目的 对叶酸、维生素B12(VB12)、二甲双胍联用对2型糖尿病(T2DM)患者的治疗作用。方法 选取2021年2月至2023年3月浙江省医疗健康集团长兴医院收治的112例T2DM患者，采用随机数字表法分为对照组(VB12+二甲双胍，56例)和研究组(叶酸+VB12+二甲双胍，56例)。对比血糖、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平、胰岛素抵抗指数(HOMA-IR)和同型半胱氨酸(Hcy)水平、临床疗效、CD4+、CD8+、CD4+/CD8+水平、Th1、Th17、Th1/Th17水平，不良反应及并发症。结果 治疗后，研究组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、HOMA-IR、HbA1c、FINS和Hey均低于治疗前与对照组(P＜0。05);研究组总有效率更高(P＜0。05);治疗后研究组CD4+、CD4+/CD8+均高于治疗前和对照组(P＜0。05)，CD8+低于治疗前和对照组(P＜0。05);治疗后，研究组Th1、Th17水平低于治疗前和对照组(P＜0。05)，Th1/Th17高于治疗前和对照组(P＜0。05);2组患者不良反应发生率比较差异无统计学意义(P＞0。05);研究组并发症发生率低于对照组(P＜0。05)。结论 叶酸与VB12、二甲双胍联用治疗T2DM有助于控糖，还可提高免疫，调节Th1/Th17平衡，且安全可靠，有助于减少并发症。
Therapeutic effects of folic acid combined with vitamin B12 metformin in patients with type 2 diabetes mellitus
Objective To investigate the therapeutic effect of folic acid and vitamin B12 in type 2 dia-betes mellitus(T2DM).Methods A total of 112 patients with T2DM in Changxing Hospital,Zhejiang Medical and Health Group from February 2021 to March 2023 were randomly divided into a control group(treated with vitamin B12 and metformin)and a study group(treated with folic acid,vitamin B12,and metformin),with 56 cases in each group.Compare the blood glucose glycated hemoglobin(HbA1c),fasting insulin(FINS),HOMA-IR,homocys-teine(Hcy),clinical efficacy,CD4+、CD8+、CD4+/CD8+,Th1,Th17,Th1/Th17,adverse reactions,and complications.Results After treatment,FPG,2 h PG,HOMA-IR,HbA1c,FINS and Hcy in the study group were lower than those before treatment and in the control group(P＜0.05).The total effective rate of the study group was higher(P＜0.05).After treatment,CD4+,CD4+/CD8+in the study group were higher than those before treatment and in the control group(P＜0.05),while CD8+was lower(P＜0.05).After treatment,the levels of Th1 and Th17 in the study group were significantly lower than those before treatment and the control group(P＜0.05),while the ratio of Th1/Th 17 in the study group was higher than those before treatment and the control group(P＜0.05).The adverse reac-tions were similar in both groups(P＞0.05).The incidence of complications in the study group was lower than that in the control group(P＜0.05).Conclusion It is helpful to reduce blood glucose level with the combination of folic acid,vitamin B12 and metformin in T2DM patients,which can also reduce insulin resistance,improve clinical effi-cacy and immunity,and regulate Th1/Th17 balance.This safe and reliable treatment can reduce complications.
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