降糖、降压药联合甲钴胺、叶酸治疗2型糖尿病合并高血压临床研究

发布时间：2018-03-06 12:37

本文选题：糖尿病　切入点：高血压　出处：《内蒙古大学》2017年硕士论文　论文类型：学位论文

【摘要】：为探讨降糖、降压药物联合甲钴胺、叶酸片治疗2型糖尿病合并高血压的临床疗效及其安全性,以期找到治疗2型糖尿病合并高血压的联合用新药模型,本研究选取内蒙古自治区包头市扶贫医院(本院)门诊2015年10月1日以前就诊登记的160例2型糖尿病合并高血压的患者作为研究对象,积极联系患者,并在患者知情、同意并能够耐受治疗药物的前提下开展本研究。将纳入对象随机分为两组(实验组与对照组,每组80例)。两组患者均参与统一标准的降糖、降压药治疗:降糖药二甲双胍0.75mg/d,降压药卡托普利25-50mg,一天三次。实验组联合使用甲钴胺0.5mg,一天一次,及叶酸80mg,一天一次;对照组同时服用安慰剂。自2015年10月1日起连续治疗1年后,通过降糖有效率、降压有效率、生化指标改善情况、并发症发生率以及不良反应发生率评价药物的有效性及安全性。结果表明:(1)治疗糖尿病疗效统计及比较:实验组和对照组两组比较好转率无差异(P0.05)。而实验组显效率及总有效率均高于对照组,且差异有统计学意义(P0.05)。(2)治疗高血压疗效统计及比较结果显示,实验组好转率、显效率及总有效率均高于对照组,且差异有统计学意义(P0.05)。(3)两组各项生化指标统计及比较,两组治疗前后各项指标均有所改善。实验组FBG、LDL、TG、Cr、尿Pr明显降低、且与治疗前比较差异有显著性(P均0.05);对照组治疗前后各项指标降低水平无统计学意义(P0.05);治疗后两组各项指标比较均有差异、且有统计学意义(P0.05)。(4)并发症比较:两组比较冠心病、视网膜病变、肾功能异常、周围神经病变的发生实验组明显低于对照组,差异有统计学意义(P0.05)。脑中风的发病率两组比较无差异(P0.05)。(5)药物不良反应统计及比较:两组患者均未出现严重的药物不良反应,每组各有2例患者出现恶心呕吐或下肢水肿,但均在药物减量或短暂停药后缓解,能够继续本研究。结论:降糖、降压药物联合甲钴胺、叶酸片治疗2型糖尿病合并高血压的临床疗效确切,可以提高疗效、降低并发症的发生、改善患者生化指标并具有较少的不良反应。因此可以作为治疗2型糖尿病合并高血压的联合用药模型被临床使用。
[Abstract]:In order to explore the clinical efficacy and safety of hypoglycemic drugs combined with mecobalamin and folic acid tablets in the treatment of type 2 diabetes mellitus with hypertension, we hope to find a new combined drug model for the treatment of type 2 diabetes mellitus with hypertension. In this study, 160 patients with type 2 diabetes complicated with hypertension were selected from the outpatient clinic of Baotou Poverty Alleviation Hospital, Inner Mongolia Autonomous region, before October 1st 2015. The subjects were randomly divided into two groups (experimental group and control group, 80 cases in each group). Antihypertensive drugs: metformin 0.75 mg / d, captopril 25-50 mg / d, three times a day. The experimental group was treated with mecobalamin 0.5 mg once a day and folic acid 80 mg once a day. The control group took placebo at the same time. After one year of continuous treatment since October 1st 2015, the effective rate of lowering blood pressure, the effective rate of lowering blood pressure, and the improvement of biochemical index were improved. The incidence of complications and adverse reactions were used to evaluate the efficacy and safety of the drug. The results showed that there was no difference in the improvement rate between the experimental group and the control group (P 0.05). The results showed that there was no difference between the experimental group and the control group (P 0.05). The rate and the total effective rate were higher than those in the control group. The statistical and comparative results showed that the improvement rate, effective rate and total effective rate in the experimental group were higher than those in the control group, and the difference was statistically significant. The indexes of the two groups were improved before and after treatment, and the levels of TGG Cr and urine pr in the experimental group were significantly lower than those in the control group, and there was no significant difference between the two groups before and after treatment. There were significant differences between the two groups before and after treatment (P < 0.05), and there was no significant difference between the two groups before and after treatment (P < 0.05), and there was significant difference between the two groups (P < 0.05) after treatment, and there was significant difference between the two groups (P < 0.05) and the complications were: coronary heart disease (CHD) was compared between the two groups, and no significant difference was found between the two groups before and after treatment (P < 0.05). The incidence of retinopathy, abnormal renal function and peripheral neuropathy in the experimental group was significantly lower than that in the control group. There was no significant difference in the incidence of cerebral apoplexy between the two groups (P 0.05, P 0.05, P 0.05) and the adverse drug reactions: there were no serious adverse drug reactions in the two groups, and two patients in each group had nausea, vomiting or edema of the lower extremities. Conclusion: hypoglycemic, hypotensive drugs combined with mecobalamin and folic acid tablets are effective in the treatment of type 2 diabetes mellitus with hypertension. Therefore, it can be used as a combined drug model for the treatment of type 2 diabetes mellitus with hypertension.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R544.1

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