二甲双胍辅助内镜治疗家族性腺瘤性息肉病疗效及安全性研究  

Efficacy and safety of metformin in the treatment of familial adenomatous polyposis

作　　者：孙东杰 李海涛[2,3,4] 徐桂林 曾祥鹏[2,3,4] 陈丽斌 程志成 李达周 叶舟 罗宝祥[3] 周琳鑫 王雯 SUN Dong-jie;LI Hai-tao;XU Gui-lin;ZENG Xiang-peng;CHEN Li-bin;CHENG Zhi-cheng;LI Da-zhou;YE Zhou;LUO Bao-xiang;ZHOU Lin-xin;WANG Wen(Department of Digestive Diseases,Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350025,China;Department of Digestive Diseases,The Fuzong Clinical Medical College,Fujian Medical University,Fuzhou 350025,China;Department of Digestive Diseases,Oriental Hospital Affiliated to Xiamen University,Fuzhou 350025,China;Department of Digestive Diseases,900th Hospital of PLA,Fuzhou 350025,China;Department of Digestive Diseases,Cangshan Hospital of 900th Hospital of PLA,Fuzhou 350025,China)

机构地区：[1]福建中医药大学附属福总教学医院消化内科,350025 [2]福建医科大学附属福总临床医学院消化内科,350025 [3]厦门大学附属东方医院消化内科,350025 [4]联勤保障部队第900医院消化内科,350025 [5]联勤保障部队第900医院仓山院区消化内科,350025

出　　处：《现代消化及介入诊疗》2022年第11期1381-1387,共7页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(82100687);福建省科技创新联合资金项目(2018Y9116);福建中医药大学校管临床专项(XB2021186);联勤保障部队第900医院院内课题(2021MS20)。

摘　　要：目的观察二甲双胍辅助内镜治疗家族性腺瘤性息肉病疗效及安全性。方法纳入衰减型家族性腺瘤性息肉病患者48例为研究对象,按随机数字表法分为高剂量二甲双胍组(A组)、低剂量二甲双胍组(B组)及对照组(C组)各16例,三组患者均测量体重、腹围、BMI后行电子结肠镜检查,于距肛15 cm处行纳米炭标记,切除并记录肠道中所有≥10 mm息肉及标记点肛侧息肉。A组在内镜治疗基础上口服二甲双胍500 mg bid,B组在内镜治疗基础上口服二甲双胍500 mg qd,C组仅进行内镜治疗,随访6个月观察不良反应发生情况,随后复查肠镜记录并切除全大肠≥10 mm息肉及标记点肛侧所有息肉,复测体重、腹围、BMI及抽血查糖化血红蛋白、空腹血糖、血脂、肝功能、肾功能、血常规等指标,比较三组患者全大肠≥10 mm息肉数量、距肛15 cm肛侧息肉数量、不良反应及各项指标差异。结果三组患者全大肠≥10 mm息肉数量、距肛15 cm内息肉数量均较治疗前明显减少(P<0.05),治疗后A组及B组全大肠≥10 mm息肉数量、距肛15 cm内息肉数量均明显少于C组(P<0.05);A组及B组体重、腹围、BMI均较治疗前下降(P<0.05),而C组治疗前后未见明显差异(P>0.05)。三组间糖化血红蛋白、空腹血糖、血脂、肝功能、肾功能、血常规等指标未见明显差异(P>0.05)。结论二甲双胍可辅助内镜治疗家族性腺瘤性息肉病,并可降低患者体重、腹围、BMI,相对安全。Objective To observe the efficacy and safety of metformin assisted endoscopy in the treatment of familial adenomatous polyposis.Methods Attenuation type familial adenomatous polyp patients in 48 cases as the research object,according to random number table method is divided into high doses of metformin group(group A,n=16),low doses of metformin group(group B,n=16)and the control group(group C,n=16).Three groups of patients were measured weight,BMI abdominal circumference.Electronic colonoscopy was performed after line nano carbon mark in 15 cm from the anus,all polyps≥10 mm and marked anal polyps were resected and recorded.Group A was given metformin 500 mg bid on the basis of endoscopic therapy,group B was given metformin 500 mg qd on the basis of endoscopic therapy,and group C was only given endoscopic therapy.The adverse reactions were observed during the 6-month follow-up.Then,colonoscopy was used to record and remove polyps≥10 mm in the large intestine and all polyps in the anus at the marker point.Weight,abdominal circumference,BMI were measured again,and blood samples were taken to check the indicators of glycated hemoglobin,fasting blood glucose,blood lipids,liver function,kidney function and blood routine tests.The number of total intestinal polyps≥10 mm,the number of anal polyps 15 cm away from the anus,adverse reactions and the differences in various indicators were compared among the three groups.Results The number of polyps in the whole intestine≥10 mm and within 15cm from the anus in the three groups were significantly decreased compared with before treatment(P<0.05),and the number of polyps in the whole intestine≥10 mm and within 15cm from the anus in the group A and B were significantly decreased compared with the group C after treatment(P<0.05).The body weight,abdominal circumference and BMI of group A and group B were decreased compared with those before treatment(P<0.05),while there were no significant differences before and after treatment in group C(P>0.05).There were no significant

关 键 词：家族性腺瘤性息肉病 二甲双胍 疗效 安全性 

分 类 号：R574.62[医药卫生—消化系统]