糖尿病合并肺结核患者不同降糖治疗方案与抗结核治疗的有效性探究  

Study on the effectiveness of different hypoglycemic therapy and anti-tuberculosis therapy in diabetic patients with pulmonary tuberculosis

作　　者：唐颖婧 Tang Yingjing(The Third Department of Internal Medicine,Hunan Chest Hospital,Hunan Changsha 410000)

机构地区：[1]湖南省胸科医院内三科,湖南长沙410000

出　　处：《中国社区医师》2021年第15期48-49,共2页Chinese Community Doctors

摘　　要：目的:探究糖尿病合并肺结核患者采用不同降糖治疗方案与抗结核的疗效。方法:2016年3月-2018年3月收治糖尿病合并肺结核患者30例,按不同治疗方法分为两组,各15例。两组患者均采取糖尿病综合治疗法进行治疗,包括心理疏导、糖尿病饮食控制结合适当运动及医学营养治疗和血糖监测等方式;试验组患者采用早晚餐前皮下注射预混门冬胰岛素30的方式展开治疗;对照组则采用口服二甲双胍、格列美脲、阿卡波糖等口服降糖药的方式进行治疗。根据患者血糖的监测结果,分别调整胰岛素及降糖药的剂量。两组肺结核患者的治疗方案都是3HRZE/15HRE,其中H是INH异烟肼,R是RFP利福平,Z是PZA吡嗪酰胺,E是EMB乙胺丁醇,具体剂量则依据常规的体重进行计算,并且依据具体病情进行适量的增减;治疗时间为12~18个月。比较两组治疗效果。结果:试验组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:相对于口服降糖药,胰岛素更利于糖尿病合并肺结核患者的治疗。Objective:To explore the efficacy of different hypoglycemic therapy and anti-tuberculosis therapy in diabetic patients with pulmonary tuberculosis.Methods:From March 2016 to March 2018,30 cases of diabetic patients with pulmonary tuberculosis were enrolled,they were divided into two groups according to different treatment methods,with 15 cases in each group.Both groups were treated with comprehensive diabetes therapy,included psychological counseling,diabetes diet control combined with appropriate exercise,medical nutrition treatment and blood sugar monitoring.The experimental group was treated with premixed insulin aspart 30 subcutaneously before breakfast and dinner on the basis of conventional treatment.The control group was treated with oral metformin,glimepiride,acarbose and other oral hypoglycemic drugs.The treatment plan for pulmonary tuberculosis in both groups was 3 HRZE/15 HRE.The H was isoniazid,the R was rifampicin,the Z was pyrazinamide,the E was acetobutanol.Specific doses were calculated on the basis of conventional weight,an appropriate amount of increase or decrease was made according to the patient's condition.The treatment time was 12-18 months.The therapeutic effects between the two groups was compared.Results:The total effective rate of treatment in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with oral hypoglycemic drugs,insulin is more beneficial to the treatment of diabetic patients with tuberculosis.

关 键 词：糖尿病 肺结核 胰岛素降糖 口服药降糖 临床疗效 

分 类 号：R587.3[医药卫生—内分泌] R521[医药卫生—内科学]