糖尿病二甲双胍的治疗.doc

临 床 药 理 学 学号：0825700008 二甲双胍治疗糖尿病 （XX 08级临床3班 成都） 【摘要】二甲双胍可通过减少肝脏葡萄糖输出,提高胰岛素的敏感性,改善胰岛素抵抗等作用降低血糖。目前,美国糖尿病联合会和欧洲糖尿病研究学会达成共识,认为二甲双胍是治疗2型糖尿病的一线用药并贯穿治疗始终。从另外一方面，二甲双胍能改善糖脂代谢,改善胰岛素抵抗,减轻体质量,对心血管有良好的保护作用,是众多口服降糖药物中的一线用药,是一线治疗的最佳选择。近年来对二甲双胍降糖作用以外的临床应用研究不断深入,已被应用于多囊卵巢综合征,非酒精性脂肪性肝病等多种疾病的治疗。二甲双胍最常见的不良反应为胃肠道反应,乳酸酸中毒则非常罕见,故能安全地用于糖尿病前期与糖尿病的治疗。 【关键字】糖尿病；二甲双胍 ；临床应用；副作用 【Abstract】Metformin can increase the sensitivity of insulin and ameliorate the insulin resistance through decreasing the output of hepatic glycogen1 American Diabetes Association and European Association for the Study of Diabetes have reached the consensus that Metformin is the first-line drug in the treatment of diabetes and should be app lied during the whole course. On the other hand, Metformin can improve glycometabolism and lipidmetabolism, ameliorate insulin resistance, reduce bodyweight, and has protective effects on cardiovascular system1Metformin is usually the first-line medication used for treatment of type 2 diabetes mellitus. In recent years, the researches on the clinical application of metformin is not only limited to its role as one of oral hypoglycemic agent, but also the application of the therapy of other diseases , such as polycystic ovarian syndrome, nonalcoholic fatty liver disease and so on. In the near future, more and more studies will be performed1. The most common adverse reactions 共7页，第1页 of metformin is the gastrointestinal reactions, and lactic acidosis is very rare, as a result, it could be used in pre-diabetes and diabetes treatment safely. 【Keywords】Diabetes; Metformin; clinical application; side effects 前言 糖尿病是全球第4位致死性疾病，在中国是第3位致死因素。目前全球约有2.39亿人患有糖尿病。中国约有2500万糖尿病患者，若加上潜在人群，受糖尿病威胁的总数达到4000万人。到2025年，中国患者预计可达5000万以上。糖尿病是由于遗传、环境、免疫等因素相互作用，导致胰岛素分泌绝对或相对不足，引起蛋白质、脂肪、水和电解质等一系列代谢紊乱综合征。[1]而二甲双胍的临床作用包括控制血糖和糖尿病的