葡甘聚糖治疗2型糖尿病的疗效及安全性  

Evaluation of therapeutic effect of glucomannan in type 2 diabetes

作　　者：顾耀[1] 王小燕[2] 李文君[1] 石莹[1] 

机构地区：[1]同济大学附属上海市第十人民医院内分泌科,上海200072 [2]上海市医学会

出　　处：《上海医学》2005年第12期1018-1023,共6页Shanghai Medical Journal

摘　　要：目的观察2型糖尿病患者进食不同剂量葡甘聚糖后,空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素、餐后2 h胰岛素和血脂的变化,并评价其安全性.方法选择140例2型糖尿病患者,均分为4组.伏格列波糖组予伏格列波糖口服;低、中、高剂量组分别予葡甘聚糖10、20和30 g/d口服.4组患者均供给含纤维素量基本一致的蔬菜500 g/d,个体膳食纤维的摄入量为10 g/d,以保证个体间纤维素量一致.结果①血糖、胰岛素:治疗12周后,4组患者的FBG、P2hBG、糖化血红蛋白(HbA1c)、空腹胰岛素、餐后2 h胰岛素均显著下降(P＜0.01),以伏格列波糖组的降幅最大,低、中剂量组的降幅均显著小于高剂量组(P值均＜0.05).②血脂:治疗12周后,4组患者的胆固醇(TCh)、低密度脂蛋白-胆固醇(LDL-C)水平均显著下降(P值均＜0.01),低、中剂量组的降幅显著小于高剂量组(P值均＜0.05),高剂量组显著小于伏格列波糖组(P＜0.05).③体重指数(BMI)、腰臀比(WHR):治疗12周后,低、中、高剂量组的BMI、WHR均明显下降(P值均＜0.01),以高剂量组的降幅最大,而伏格列波糖组治疗前、后的差异无显著性.④不良反应:高剂量组4例(11.42%)有轻度腹胀,1例轻度腹泻,3～6 d后自然好转;3例出现饥饿感,可自然适应,无需增加进食量.中剂量组2例(5.71%)有轻度腹胀,3～6 d后自然好转.结论葡甘聚糖低、中、高3个剂量均具有降低血糖、胰岛素、血脂和减肥的疗效,其安全性、耐受性良好.与中、低剂量的葡甘聚糖相比,高剂量葡甘聚糖对控制FBG、P2hBG及降低胰岛素、血脂水平的疗效更好.Objective To investigate the changes of fasting blood glucose level （FBG）, 2 hours postprandial blood glucose level （2hBG）, fasting serum insulin concentration （Fins）, 2 hours postprandial serum insulin concentration （2hIns） and lipid profile in type 2 diabetics with different doses of water soluble fiber （glucoman nan）, and to evaluate its safety as well. Methods A total of 140 subjects participated in the clinical trial and were randomized into 4 groups, namely, positive control group with Voglibose, low dose group with glucomannan 10 g/d, median-dose group with glucomannan 20 g/d, and high dose group with glucomannan 30 g/d. The diets of all participantes were previously adjusted according to the guideline individually and were asked to eat various kinds of vegetables 500 g/d to ensure the amount of basal daily dietary fiber intake approximately 10 g. Results① After 12 weeks of intervention, FBG, 2hBG, HbA1 c, Fins and 2hIns decreased markedly in all 4 groups （P〈 0.01）, with maximal reduction in the positive control group. The amplitude of the reduction in the low dose and median-dose groups were all lower than that in the high-dose group （P〈0.05）. ② Lipid profile. After 12 weeks of intervention, TCh and LDL1c decreased markedly in all 4 groups （P〈0.01）. The amplitude of the reduction in the low dose and median-dose groups were all lower than the high-dose group （P〈0.05） but higher than the positive control group. ③ BMI and WHR： With the exception of positive control group, BMI and EHR lowered in all groups with different doses of glucomannan （P〈0.01）, with maximal reduction in the high dose group. ④ Adverse events： In the high dose group, 4 cases complained of mild abdominal distension （11.42%）, and 1 case with mild diarrhea which disappeared after 3-6 days automatically, 3 cases fell hungry and no further diet modifi cation was needed. In the media-dose group, 2 cases complained of mild abdominal distension （5.71%） and disappeared after 3

关 键 词：葡甘聚糖 2型糖尿病 血糖 胰岛素 血脂 

分 类 号：R587.1[医药卫生—内分泌] R318.08[医药卫生—内科学]