目的:糖尿病合并肺結核病的臨床治療效果的觀察。方法:對我院2004~2008年收治糖尿病合并初治肺結核病56例患者的臨床資料進行分析。結果:糖尿病合并初治肺結核病患者病情進展快,癥狀較重。血糖控制情況明顯影響肺結核治療效果。結論:積極控制血糖是治療糖尿病合并初治肺結核病的關鍵。
目的:觀察采用疏血通注射液聯合ACEI/ARB治療早期糖尿病腎病(DN)的療效。方法:將78例2型DN患者隨機分為對照組(ACEI/ARB)和治療組(ACEI/ARB+疏血通注射液),療程4周。比較兩組治療前和治療后尿微量白蛋白(mAlb),Scr、BUN等指標的變化。結果:(1)治療后治療組和對照組尿白蛋白均顯著下降(Plt;0.01,Plt;0.05),治療組比對照組下降更為明顯(Plt;0.05)。(2)治療后兩組血漿白蛋白均增加(Plt;0.01),治療組與對照組治療后比較無明顯差異(Pgt;0.05)。(3)治療后兩組Scr、BUN、TC、TG和血鉀均無明顯變化。結論:聯合應用疏血通注射液能有效減少早期DN患者的蛋白尿,改善腎功能。
目的:比較優泌樂(賴脯胰島素)與優泌林R(常規人胰島素)改善餐后2 h血糖波動療效。方法:報道本院369例糖尿病患者強化治療。結果:優泌樂治療組餐后2 h血糖水平及血糖波動均顯著降低,且無任何顯著性不良事件或持久性低血糖發生.結論:優泌樂能夠快速有效控制2型糖尿病患者的餐后血糖,方便患者,順應性好,獲得患者的喜愛。
Objective To evaluate and select essential medicine for diabetes mellitus based on the burden of disease. Methods By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence. Results (1) Six guidelines were included, three of which were evidence-based and published from 2006 to 2011. (2) Five recommended medicines were included according to recommendations and evidence of WHOEML (2011), NEML (2009), CNF (2010) and other guidelines. They were metformin, glibenclamide, glipizide, rosiglitazone and pioglitazone. Domestic evidence of the first three drugs was evaluated. (3) The first three have been marketed with the specifications and dosage forms corresponding to guidelines in China. The FBG cost-effectiveness ratios of metformin with different dosage forms as immediate release compressed tablet, enteric-coated tablet and sustained release capsule were 3.37, 3.76 and 3.50 respectively. 2-hour BG cost-effectiveness ratios of metformin were 3.74, 4.00 and 3.71 respectively. The cost-effectiveness ratio of glibenclamide and glimepiride were 11.23 and 13.81 respectively. Conclusion We offer a recommendation for: (1) Metformin (immediate release tablet/capsule for oral use, 0.25 g), contraindicated in patients with renal insufficiency. (2) Glibenclamide (tablet, 2.5 mg; capsule, 1.75 mg) and glipizide (tablet, 2.5 or 5mg; dispersible tablet, 5 mg), contraindicated in children, women during pregnancy or lactation, patients in the perioperative period of major operation, patients after total pancreatectomy, and patients allergic or adversely reacted to sulfa drug. (3) Evidence-based and standardized primary healthcare guidelines as well as clinical and pharmacoeconomic studies on diabetes mellitus (large-scale, multi-centre, randomized and double-blinded) are needed to produce high-quality local evidence.
Methods Sixty-six postoperative patients with gastric cancer combined diabetes were divided into 3 groups according to the balanced principle. In the frist group (FD group), FD was the nutrition preparation for 21 patients. In the second group (fresubin group), fresubin and the ordinary insulin injection were the nutrition preparation for 21 patients. In the third group (TPN group), the nutrition preparation came from TPN and the ordinary insulin injection for 24 patients. FD, fresubin or TPN were given at 24 h after operation, the levels of blood glucose for empty stomach, after meal (enteral nutrition or TPN) and the common complications compared among 3 groups of postoperative patients. Results ① In FD group, the levels of blood glucose of postoperative empty stomach and after enteral nutrition were stable with little fluctuation and no insulin was needed with 1 case of hyperglycemia (4.8%). In fresubin group and TPN group, the levels of blood glucose of postoperative empty stomach and after enteral nutrition or TPN were unstable with big fluctuation, with 6 cases (28.6%) and 8 cases (33.3%) of hyperglycemia, 5 cases (23.8%) and 6 cases (25.0%) of hypoglycemia in fresubin group and TPN group, respectively. Compared with fresubin group and TPN group, the rate of pathoglycemia was lower in FD group, the difference had statistical significance separately (Plt;0.05); There was no significant difference between fresubin group and TPN group (Pgt;0.05). ② The rates of infection of incisional wound in FD group (4.8%) and fresubin group (23.8%) were lower than that of TPN group (33.3%), there was significant difference among 3 groups (Plt;0.05); The time of passage of gas by anus in FD group and fresubin group were shorter than that in TPN group (Plt;0.05); There was no significant difference between FD group and fresubin group (Pgt;0.05). There were no significant differences of the rates of abdominal distension or diarrhea among 3 groups (Pgt;0.05). Conclusion Regarding postoperative patients with gastric cancer combined diabetes, in the early time field test group of the nutrition preparation, FD is better than fresubin or TPN, which does not increase the risk of the blood glucose change and have few complications.