胰岛素对雷公藤多甙联合烟酰胺方案干预LADA疗效的影响

摘要

[Objective] To compare the clinical efficacy between insulin intensive therapy and oral hypoglycemic agent metformin with the intervention therapy of Tripterygium polyglycoside combined with Nnicotinamide on Latent onset autoimmune diabetes mellitus (LADA) patients. [Method] 62 cases of newly diagnosed LADA patients were randomly divided into insulin group (Group A) and metformin group(Group B), and the same intervention therapy was used in both of the two groups. During 24 months of follow-up intervention, 30 patients finished this clinical study in each group. [Results] Values of C-peptide in group A were significantly higher than that in group B (P＜0.05),and the values of C-peptide were increased in the both of the groups compared with the basic value before intervention (P＜0.05). ICA(+) of 10 cases in group A and 7 cases in group B became negative respectively. The level of sIL-2R and LPO was significantly decreased in both of the groups after intervention (P＜0.01～0.05). [Conclusion]Results suggested that the intervention therapy of Tripterygium polyglycoside combined with nicotinamide may play a role in the immunity regulation, decreasing the titer of islet cell antibodies and sIL-2R, protecting the islet function in the early LADA patients, which could be improved by the insulin intensive therapy.%目的对比研究胰岛素(强化治疗)与口服降糖药二甲双胍对雷公藤多甙联合烟酰胺方案干预LADA早期患者疗效的影响.方法病程在1年内LADA患者62例,随机分为胰岛素强化治疗组(A组)与二甲双胍组(B组),两组均使用相同的雷公藤多甙联合烟酰胺干预方案.随访时间24月,A、B两组实际完成随访观察各30例.结果两组C肽水平均较治疗前显著升高(P＜0.05),但A组C肽水平高于B组(P＜0.05);A组与B组分别有10例与7例ICA阳性病例转阴;两组患者的血清sIL-2R与LPO水平均较治疗前明显下降(P＜0.01～0.05).结论雷公藤多甙联合烟酰胺方案对LADDA早期患者具有调节免疫,保护残存胰岛β细胞功能的作用.胰岛素强化治疗可提高该方案的干预效果.