复方倍他米松局部给药镇痛治疗对糖尿病病人血糖水平的影响  

The blood glucose changes of locally injecting betamethasone analgesia in patients with diabetes mellitus

作　　者：邹海娟 纪秋凤 刘玉兴 王海宁[3] 杨克勤[3] 魏梦雅 许丽媛[3] 樊碧发[3] 覃旺军[1] ZOU Haijuan;JI Qiufeng;LIU Yuxing;WANG Haining;YANG Keqin;WEI Mengya;XU Liyuan;FAN Bifa;QIN Wangjun(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pain Management,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pharmacy,The Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518107,China)

机构地区：[1]中日友好医院药学部,北京100029 [2]中山大学附属第七医院药学部,深圳518107 [3]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2022年第7期502-507,共6页Chinese Journal of Pain Medicine

基　　金：中央高水平医院临床科研业务费(2022-NHLHCRF-YSPY-02-05);中央高校基本科研业务费专项资金(3332020075)。

摘　　要：目的:观察复方倍他米松局部给药镇痛治疗对糖尿病病人血糖变化及影响因素。方法:选取2020年1月至2021年4月中日友好医院疼痛科经复方倍他米松局部治疗疼痛伴糖尿病的66例病人为研究对象,比较治疗前后空腹血糖、睡前血糖变化和疼痛缓解程度,分析年龄、性别、体重指数、糖尿病病程、用药部位、空腹血糖水平等因素对血糖影响。结果:与治疗前相比,治疗后视觉模拟评分法(visual analogue scales,VAS)评分显著降低(P<0.001)。与治疗前日相比,治疗当日空腹血糖和睡前血糖均升高,升高值分别为(2.93±3.94)mmol/L和(3.78±3.96)mmol/L(P<0.001)。与治疗当日相比,治疗次日血糖水平均呈下降趋势,变化值分别为(-1.23±2.67)mmol/L和(-1.41±4.19)mmol/L(P<0.05)。单因素和多因素分析结果显示,糖尿病病程是空腹血糖波动的影响因素,性别是睡前血糖波动的影响因素。结论:复方倍他米松局部给药镇痛治疗可引起糖尿病病人血糖短暂性波动。临床医师应尤其关注并监测女性、病史长的糖尿病病人血糖水平。Objective:To investigate the changes of blood glucose in patients with diabetes mellitus(DM)after a single dose of local analgesia with betamethasone,and to analyze the related factors.Methods:Pain and DM patients who received nerve block with betamethasone from January 2020 to April 2021 in the Department of Pain management of China-Japan Friendship Hospital were included.The visual analogue scales(VAS),fasting blood glucose(FBG),bedtime blood glucose(BBG)were analyzed before and after treatment,and the influence on the changes of blood glucose by age,gender,BMI,diabetes duration,location of injection and basal glucose control in patients were explored.Results:After treatment,VAS scores were decreased significantly(P<0.001).Compared with the day before treatment,fasting and bedtime blood glucose were increased on the day before treatment,and the increased values were(2.93±3.94)mmol/L and(3.78±3.96)mmol/L respectively(P<0.001).Compared with the day of treatment,the blood glucose level showed a downward trend on the next day of treatment,and the changes were(-1.23±2.67)mmol/L and(-1.41±4.19)mmol/L respectively(P<0.05).Univariate and multivariate analysis showed that diabetes duration was the influencing factor of FBG fluctuation,while gender was the influencing factor of BBG fluctuation.Conclusion:Local administration of analgesia with betamethasone may cause transient fluctuation of blood glucose in diabetic patients.Clinical attention should be paid to monitoring blood glucose levels,especially for patients who are females and have long diabetes durations.

关 键 词：复方倍他米松 血糖 糖尿病 疼痛 

分 类 号：R587.1[医药卫生—内分泌]