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目的:观察二甲双胍在乳腺癌合并糖调节受损患者化学治疗(化疗)中血糖控制的疗效和安全性。方法 :手术病理证实为乳腺癌并行初次化疗女性中筛选出糖调节受损患者108例,随机分为治疗组(56例)和对照组(52例)。2组均进行非强化饮食控制,治疗组在化疗期间增加二甲双胍,比较2组化疗前及第6次化疗结束2周后血糖控制的疗效和糖尿病的发生率,并观察不良反应。结果:第6次化疗后,治疗组空腹血糖、餐后血糖、糖化血红蛋白(Hb A1c)、空腹胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)均低于对照组(均P<0.05)。治疗组糖尿病发生率为34.0%,对照组糖尿病发生率为53.2%(P<0.05)。2组的肝功能、肾功能、低血糖发生率无显著性差异(均P>0.05),治疗组胃肠道不良反应高于对照组(P<0.05)。结论 :二甲双胍可以在乳腺癌合并糖调节受损患者化疗中安全有效地控制血糖,减少糖尿病的发生。
Objective: To observe the efficacy and safety of metformin in the treatment of patients with impaired glucose regulation in patients with breast cancer undergoing chemotherapy (chemotherapy). Methods: One hundred and eighty patients with impaired glucose regulation were screened from women who underwent primary chemotherapy for breast cancer. The patients were randomly divided into treatment group (56 cases) and control group (52 cases). Patients in both groups were given non-intensive dietary control. The treatment group was given metformin during chemotherapy. The therapeutic effect of glycemic control and the incidence of diabetes were compared between the two groups before and after the sixth chemotherapy. The adverse reactions were observed. Results: After the sixth chemotherapy, fasting blood glucose, postprandial blood glucose, HbA1c, fasting insulin and homeostasis model assessment of insulin resistance index (HOMA-IR) in the treatment group were lower than those in the control group (all P <0.05 ). The incidence of diabetes was 34.0% in the treatment group and 53.2% in the control group (P <0.05). There was no significant difference in the incidence of liver function, renal function and hypoglycemia between the two groups (all P> 0.05). The gastrointestinal adverse reactions in the treatment group were higher than those in the control group (P <0.05). CONCLUSION: Metformin can control blood sugar safely and effectively and reduce the incidence of diabetes in patients with breast cancer complicated with impaired glucose regulation.