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二甲双胍治疗老年2型糖尿病合并肌少症的临床观察 Δ
钟雪梅 1, 2* ,陈 敏 ,凌雅韵 ,张兵钱(1. 重庆医药高等专科学校临床医学院呼吸内分泌教研室,重庆
3 #
1
1
401331;2.重庆医药高等专科学校附属第一医院内分泌科,重庆 400060;3.川北医学院附属医院内分泌科,
四川 南充 637000)
中图分类号 R969.4 文献标志码 A 文章编号 1001-0408(2025)06-0732-05
DOI 10.6039/j.issn.1001-0408.2025.06.16
摘 要 目的 探讨二甲双胍治疗老年2型糖尿病(T2DM)合并肌少症患者的疗效及安全性。方法 选择2022年1月至2024年1
月于重庆医药高等专科学校附属第一医院治疗的老年T2DM合并肌少症患者,按随机数字表法分为对照组(70例)和观察组(70
例)。在常规干预的基础上,对照组患者于睡前皮下注射甘精胰岛素注射液+每日早、中、晚餐前 30 min 皮下注射人胰岛素注射
液;观察组患者在对照组的基础上口服盐酸二甲双胍缓释片0.5 g,每日1次。两组患者均连续治疗24周。比较两组患者糖代谢
指标[空腹血糖(FBG)、餐后2 h血糖(2 hBG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、四肢骨骼肌指数(ASMI)、握
力、步行速度、脂代谢指标[血清总甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-
C)]、血清学标志物[超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、铁蛋白水平]及生活质量,并记录不良反应发生情况。结果 对
照组和观察组分别有 65、63 例患者完成本研究。治疗后,两组患者 FBG、2 hBG、HbA1c、HOMA-IR、TG、TC 及观察组患者的 hs-
CRP、IL-6、铁蛋白水平均较治疗前显著降低(P<0.05),且观察组患者的 HOMA-IR 显著低于对照组(P<0.05);观察组患者的握
力、步行速度、活动能力和日常生活情况指数均较治疗前及对照组显著增加(P<0.05)。两组患者的不良反应发生率均为2.86%。
结论 二甲双胍可降低老年T2DM合并肌少症患者的炎症因子及血清铁蛋白水平,促进肌肉质量和力量的恢复,改善胰岛素抵抗,
提高患者生活质量,且未增加不良反应的发生。
关键词 二甲双胍;2型糖尿病;肌少症;老年;安全性
Clinical observation of metformin in the treatment of diabetes mellitus type 2 complicated with sarcopenia
in elderly patients
1
1
1, 2
ZHONG Xuemei ,CHEN Min ,LING Yayun ,ZHANG Bingqian(1. Respiratory and Endocrinology Teaching
3
and Research Section, Clinical Medical College, Chongqing Medical and Pharmaceutical College, Chongqing
401331, China;2. Dept. of Endocrinology, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical
College, Chongqing 400060, China;3. Dept. of Endocrinology, the Affiliated Hospital of North Sichuan
Medical College, Sichuan Nanchong 637000, China)
ABSTRACT OBJECTIVE To investigate the efficacy and safety of metformin in the treatment of diabetes mellitus type 2
(T2DM) complicated with sarcopenia in elderly patients. METHODS From January 2022 to January 2024, clinical data from
eligible patients with T2DM complicated with sarcopenia treated at the First Affiliated Hospital of Chongqing Medical and
Pharmaceutical College were collected. Patients were randomly assigned into control group (70 cases) and observation group (70
cases) using a random number table. Both groups received routine interventions; control group additionally received subcutaneous
injections of Insulin glargine injection before bedtime and Human insulin injection 30 minutes before breakfast, lunch and dinner
every day. In addition to the same treatments as the control group, the observation group was administered 0.5 g of Metformin
hydrochloride sustained-release tablets orally once daily. Both groups were treated continuously for 24 weeks. Comparisons were
made between the two groups in terms of glucose metabolism indexes [fasting blood glucose (FBG), 2 h postprandial blood
glucose (2 hBG), and glycosylated hemoglobin (HbA1c)], homeostasis model assessment of insulin resistance (HOMA-IR),
appendicular skeletal mass muscle index (ASMI), grip strength, walking speed, lipid metabolism indexes [serum total triglyceride
(TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)],
serological markers [high-sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6), and ferritin levels] and quality of life. The
occurrence of ADR was recorded in both groups. RESULTS
Δ 基金项目 重庆市科卫联合医学科研项目(No. 2024MSXM059) 65 patients in the control group and 63 patients in the
*第一作者 主治医师,讲师,硕士。研究方向:内分泌基础与临
observation group completed this study, respectively. After
床。E-mail:ZJN_safjs@163.com
# 通信作者 副主任医师,硕士。研究方向:内分泌基础与临床。 treatment, the levels of FBG, 2 hBG, HbA1c, HOMA-IR,
E-mail:chenmin1972@sina.com TG and TC in both groups, and the levels of hs-CRP, IL-6
· 732 · China Pharmacy 2025 Vol. 36 No. 6 中国药房 2025年第36卷第6期