摘要
目的探讨不同降糖药对糖皮质激素治疗糖尿病性耳聋疗效的影响。方法选择2010年5月～2012年5月在广州市第十二人民医院内分泌科和耳鼻喉科住院的糖尿病性耳聋患者4．0例，随机分成胰岛素组和口服降糖药对照组（n=20）。胰岛素组使用胰岛素泵（门冬胰岛素，即诺和锐）控制血糖，对照组选择瑞格列奈（诺和龙）2mg、阿卡波糖（拜糖平）50mg、二甲双胍（格华止）500mg，每2～5次，每次1片控制血糖。2组同时给予糖皮质激素（予地塞米松10mg静脉滴注3d，再改服泼尼松片30mg顿服，1次／d，2周后逐渐减量，2个月后停药），静脉滴注银杏达莫注射液20mL扩张血管、前列地尔（凯时）20μg改善微循环、甲钴胺（弥可保）500μg营养神经等常规治疗，1次／d，于治疗后7d、14d行纯音听阈均值（PTA）测定与疗效评估。结果胰岛素组10例听力恢复正常，对照组6例恢复正常，胰岛素组的总有效率为95％，显著高于对照组的80％，差异有统计学意义（χ2=555，P〈0．05），治疗后7及14d2组PTA差异均有统计学意义（P〈0.05），胰岛素组总体疗效优于对照组。2组均未出现与激素有关的不良反应。结论糖皮质激素是治疗糖尿病性耳聋的有效方法，及早联合正规应用胰岛素有益于耳聋患者听力恢复。
Objective To discuss curative effect of different antidiabetic drugs on ghcocorticoid in treatment of type 2 diabetes sensorineural deafness. Methods Forty patients with type 2 diabetes sensofineural deafness who were admitted to the Department of Endocrinology and Department of Otorhinolaryngofogy, the twelfth People＇s Hospital of Guangzhou City from May 2010 to May 2012, were randomly divided into the insulin group and oral antidiabetic drugs group with 20 cases each. Patients of the insulin group were treated by transient intensive insulin Aspart treatment in the way of continuous subcutaneous insulin infusion （CSII）,the control group were treated with tablets repaglinide （NovoNorm） 2 mg, acarbose （Glucobay） 50 mg, metformin （Glucophage） 500 mg 2-3 times daily. Two groups were given to the glucocorticoid： all patients were given every day once intravenous drip dexamethasone 10 mg for 3 days,then received prednisone tablets of 30 mg 1 time daily, following it reduced doses after two weeks,the total course of two months. Simultaneously dilate blood vessels with ginkgo leaf extract and dipyridamole injection 20 mL, improve microcirculation with prostaglandin E 1 infusions 20 p g, nutrition neurological drugs treatment with Mecobalamin infusions 500 lag were administered in all patients. After the treatment 7 d and 14 d ,pure tone average （PTA） were conducted and treatment efficacy were evaluated. Results Ten cases of the insulin grot/p were recovered,6 cases of the control group were recovered. The total effective rate （95%） of the insulin group was significantly higher than that of the control group （80%）, there were significant differences （Z2=5.53,P〈O.05）. The improvement of pure tone average （PTA） at 7 d and 14 d had significant statistical difference （P〈0.05）. The total therapeutic effect in the insulin group was better than the control group. Two groups were no obvious adverse reactions associated with the use of glueocorticoid. Conclusion The patients with type 2 diabetes sensorineural deafness treated with ghcocorticoid therapy has better curative effect, and to early combine with regular insulin can significantly improve patients with clinical symptoms,
出处
《当代医学》
2014年第17期11-13,共3页
Contemporary Medicine
