| 张卫欢,郭智慧,李秋云,等.肥胖合并高胰岛素血症的综合治疗效果观察[J].安徽医药,2020,24(11):2153-2156. |
| 肥胖合并高胰岛素血症的综合治疗效果观察 |
| Study on the comprehensive treatment of obesity with hyperinsulinemia and observation of effect |
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| DOI：10.3969/j.issn.1009?6469.2020.11.009 |
| 中文关键词: 肥胖 高胰岛素血症 芬特明 奥利司他 二甲双胍 胃旁路术 治疗结果 |
| 英文关键词: Obesity Hyperinsulinemia Phentermine Orlistat Metformin Gastric bypass Treatment outcome |
| 基金项目:河北省卫生计生委支撑项目(20160758) |
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| 中文摘要: |
| 目的探讨肥胖合并高胰岛素血症病人的综合治疗措施，并观察其效果。方法选取 2017年 3月至 2018年 11月开滦总医院收治的肥胖合并高胰岛素血症病人 92例，利用计算机软件生成的随机数表分为两组，对照组仅给予基础治疗，包括饮食、运动疗法和芬特明口服，观察组在上述疗法的基础上给予口服奥利司他、二甲双胍和胃旁路手术治疗。比较两组治疗前、 3个月、 6个月后体质量指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(IR)水平变化，比较两种方案对肥胖的疗效、对高胰岛素血症的疗效，病人满意度，分析安全性。结果两组 BMI、FPG、FINS、IR组间、时间、交互对比均差异有统计学意义(P＜0.05)两组 BMI、FPG、FINS和 IR均随着时间的延长下降(P＜0.05)，且观察组治疗 3个月、 6个月后 BMI、FPG、FINS和 IR均低于对照组(，P＜0.05)；两组对肥胖的疗效、对高胰岛素血症的疗效分布比较，均差异有统计学意义(P＜0.05)，观察组对肥胖的总有效率 93.48%和对高胰岛素血症的总有效率 95.65%均高于对照组 73.91%和 78.26%(P＜0.05)；观察组病人对治疗方案操作(91.30%比 69.57%)、有效性(93.48%比 67.36%)、舒适度的满意率(97.83%比 69.57%)均高于对照组(P＜0.05)；对照组未见副作用，观察组有 1例低血糖、未见术后并发症，两组对比差异无统计学意义(P＞0.05)。结论对肥胖合并高胰岛素血症病人在饮食、运动疗法和基础药物治疗的同时给予专科药物和手术治疗可降低 BMI、FPG、FINS和 IR，控制肥胖、降低高胰岛素血症，提高病人满意率，安全可靠。 |
| 英文摘要: |
| Objective To study the comprehensive treatment of obesity patients with hyperinsulinemia and to observe its effect. Methods Ninety?two obese patients with hyperinsulinemia were divided into two groups in Kailuan General Hospital from March2017 to November 2018.The basic group was only given basic treatment，including diet，exercise therapy and phentermine.On the basis of the above treatment，the study group was given orlistat，metformin and surgical treatment.The changes of body mass index(BMI)fasting blood glucose(FPG)，fasting insulin(FINS)and insulin resistance index(IR)were compared before，3 months and 6months，after treatment.The effect of two schemes on obesity，hyperinsulinemia and patient satisfaction were compared.The safety was analyzed.Results There were significant differences in BMI，FPG，FINS，IR，time and interaction between the two groups(P＜0.05).BMI，FPG，FINS and IR in the two groups decreased with the prolongation of time(P＜0.05)，and BMI，FPG，FINS and IR in the study group were lower than those in the basic group after 3 months and 6 months of treatment(P＜0.05).There were signifi? cant differences in the efficacy of obesity and hyperinsulinemia between the two groups(P＜0.05).The total effective rates of obesi? ty(93.48% vs.73.91%)and hyperinsulinemia(95.65% vs.78.26%)in the study group were higher than those in the basic group(P＜0.05).The satisfaction rates of operation(91.30%比 69.57%)，effectiveness(93.48%比 67.36%)and comfort of the treatment plan(97.83%比 69.57%)in the study group were higher than those in the basic group(P＜0.05).There was no side effect in the basic group，1 case of hypoglycemia and no postoperative complications in the study group.There was no significant difference betweenthe two groups(P＞0.05).Conclusion In addition to diet，exercise therapy and basic drug therapy，special drugs and surgical treatment can control BMI，FPG，FINS and IR in obese patients with hyperinsulinemia.The curative effect of obesity and hyperinsu? linemia is remarkable，and it can also reach the satisfaction of patients，safe and reliable. |
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