【摘要】 目的探讨替米沙坦联合α-硫辛酸改善2型糖尿病合并非酒精性脂肪肝患者胰岛素抵抗的效果。方法将62例2型糖尿病合并非酒精性脂肪肝患者随机分为对照组和观察组,对照组采用格列美脲治疗,观察组在此基础上加用替米沙坦联合α-硫辛酸干预治疗,均治疗8周。观察患者治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白,以及血压、血脂等基础指标的变化情况,检测和计算两组患者胰岛素和胰岛素抵抗指数(HOMA-IR)。结果与治疗前相比,两组患者胰岛素、HOMA-IR和血脂以及空腹血糖水平、餐后2 h血糖、糖化血红蛋白浓度明显降低(P<0.05),且观察组较对照组下降更明显(P<0.05)。两组患者血压有下降趋势,观察组虽更明显,但无统计学差异(P>0.05)。结论替米沙坦联合α-硫辛酸较单用格列美脲方案,能明显改善胰岛素抵抗效应,且对血压等基础指标影响较小,安全性及耐受性较佳。更多还原

【Abstract】 Objective To investigate the effect of telmisartan combined with α-lipoic acid on the insulin resistance in type 2 diabetes mellitus( T2DM) complicating non-alcoholic fatty liver disease( NAFLD). Methods 62 patients with T2 DM complicating NAFLD were randomly divided into the control group and the observation group. The control group was treated by glyburide,while on this basis the observation group was added with the intervention of telmisartan combined with α-lipoic acid. The two groups were treated for 8 weeks.The basic indexes changes of fast blood glucose( FBG),postprandial 2 h glucose( 2h PG),glycated hemoglobin,blood pressure and blood lipids were detected. The insulin and the homeostasis model assessment of insulin resistance( HOMA-IR) were calculated in the two groups. Result s The levels of insulin,HOMA-IR,blood lipids,FBG,2h PG and glycated hemoglobin after treatment in the two groups were significantly decreased compared with before treatment( P < 0. 05),while which in the observation was more significant( P < 0. 05).The blood pressure showed the downward trend, while which in the observation was more significant, but without statistical difference( P > 0. 05). Conclusion The therapy of telmisartan combined with α-lipoic acid can more significantly improve the insulin resistant effect than single use of glyburide,moreover has little effect on the basic indexes of blood pressure,etc. and is safe and better tolerable.更多还原