摘要
目的观察2型糖尿病腹泻患者应用马来酸曲美布汀治疗效果及胃肠动力的变化。方法 52例2型糖尿病腹泻患者随机化数字表法分为A组(25例)和B组(27例),在降糖治疗基础上A组给予止泻对症治疗,B组给予马来酸曲美布汀治疗;治疗12周后评价疗效;10例无腹泻的2型糖尿病患者为对照组(C组)。以氢呼气试验检测的口-结肠转运时间(OCTT)作为胃肠动力评价指标,放射免疫法检测治疗前后血浆生长抑素(SS)、胃动素(MTL)和胃泌素(GAS)水平变化。结果①疗程结束后A组总有效率为68.0%(17/25),B组为92.6%(25/27),B组疗效优于A组(P<0.05)。②治疗前,A组与B组OCTT比较无统计学意义(76.3±18.9)min vs(76.6±20.7)min(P>0.05),但均显著低于C组(106.9±8.5)min(P<0.01);治疗后A组与B组OCTT分别为(86.8±16.1)min和(99.0±11.2)min,均较治疗前显著延长(P<0.01),且B组明显长于A组(P<0.01)。③治疗前,A组与B组血浆MTL与GAS均明显高于C组(P<0.01),SS水平低于C组(P<0.01);治疗后,两组SS、MTL和GAS均较治疗前明显改善,且B组改善改为明显(P<0.01)。结论马来酸曲美布丁治疗2型糖尿病腹泻具有良好的临床疗效,可能与调节胃肠激素水平分泌,改善胃肠动力紊乱有关,且其不良反应少且轻微。
Objective To observe the clinical therapeutic effect of trimebutine maleate in treating type 2 diabetes mellitus（T2DM） patients with diarrhea and the changes of gastrointestinal motility. Methods Fifty-two T2DM patients with diarrhea were randomly divided into group A （25 cases） and group B （27 cases） by digital table method. On the basement of hypoglycemic therapy, patients in group A were given anti-diarrhea treatment, and those in group B were treated with trimebutine maleate, and the clinical efficacy was evaluated after treatment for 12 weeks. Another 10 cases of T2DM patients without diarrhea were selected as control group（group C）. The oral-colon transit time（OCTT） as a gastrointestinal dynamic evaluation index was detected by hydrogen breath test. The changes of plasma somatostatin（SS） ,motilin（MTL） and gastrin（GAS） levels were measured by using radioimmunoassay. Results （1）The total effective rate of group A and group B were 68.0% and 92.6%, and group B was better than group A（P〈0.05）. （2）There was no statistic difference of OCTT before treatment between group A and group B（76.3 ± 18.9） rain vs （76.6±20.7） min（ P 〉0.05）, but each of them was significantly lower than that of group C（106.9±8.5） min（ P 〈0.01）. After treatment,the OCTT in group A and group B was （86.8±16.1） min and （99±11.2）min,respectively, which were longer than before treatment （ P 〈0.01） ,and the OCTT in group B was＇ significantly longer than that of group A （ P〈0.01）. （3）Before treatment, the levels of plasma MTL and GAS of group A and B were significantly higher than those in group C （P 〈0.01）,and the SS level was lower than that in group C （P 〈0.01）; After treatment, the levels of SS, MTL and GAS of two groups were significantly improved as compared with before treatment,and the changes of group B were more obvious （ P 〈 0.01）. Conclusion Trimebutine maleate has good clinical efficacy in treatment of T2DM with diarrhe
出处
《临床荟萃》
CAS
2013年第12期1343-1345,1348,共4页
Clinical Focus
关键词
糖尿病
2型
腹泻
胃肠动力
曲美布汀
diabetes mellitus, type 23 diarrhea
gastrointestinal motility
trimebutine maleate
