合併用藥對糖尿病併發症之影響

Medications for the Impact on the Diabetic Complications

葉志強(Chih-Chiang Yeh)

指導教授 ： 張淑美

國立臺北科技大學/工程學院/有機高分子研究所/碩士(2005年)

https://doi.org/10.6841/NTUT.2005.00315

摘要

本研究以國家衛生研究院87-92年健保資料中經過歸人處理擷取五年內曾經發生腎病變(24.4%)、大血管病變(25.4%)、神經病變(5%)及視網膜病變(10.7%)暨合併高血壓(71.1%)、高血脂用藥(48.81%)之糖尿病病人的資料，分析比較評估台灣地區醫師對糖尿病病人處方模式並探討藥品分子結構暨作用機轉對前述併發症發生率之影響。同時分析職業、婚姻狀態、教育程度對糖尿病發生率的影響。並探討病齡長短對併發症相對發生率衝擊。
特別分析糖尿病合併高血壓{乙醯反轉酶抑制劑 (ACEI)、乙型阻劑(β-BLOCKER) 、 鈣離子阻斷劑(CALCIUM CHANNEL BLOKER)、 利尿劑(DIURATIC) 、 ARB 藥劑、甲型阻斷劑(α-BLOCKER)}暨高血脂用藥(HMG-CoA與 FIBRATE)之處方行為 。
發現糖尿病病患合併乙醯反轉酶抑制劑 (ACEI)作為高血壓治療為大宗且對腎病變、眼睛病變、暨心血管病變之發生率較低，甚或有預防併發症之效果。糖尿病病患合併FIBRATE藥劑作為合併高血脂症狀病患之治療為大宗。

關鍵字

乙醯反轉酶抑制劑 (ACEI) ； 乙型阻劑(β-BLOCKER) ； 鈣離子阻斷劑(CALCIUM CHANNEL BLOKER) ； 利尿劑(DIURATIC) ； ARB 藥劑 ； 甲型阻斷劑(α-BLOCKER)

並列摘要

The aims of the study are to investigate and analyze the National Health Insurance Database from 1998-2003 for the diabetic epidemiology of Nephropathy (24.4%)、Macrovascular Complications (25.4%)、Neuropathy (5%) and Retinopathy (10.7%), in addition the combination therapies for hypertension (71.1%) and dyslipidemia (48.81%) of diabetic patients are also taken into the retrospective statistics. Furthermore, the prescription behavior in Taiwan, the molecular structures of the medicines and the mechanism of the medical pathway are accounted to the impact on the complications. Patients’ profiles, like occupations, marital status, education status are stratified for the impact on diabetics, together with the patients’ diabetic histories.
In particular, the molecular structures, pharmaco-dynamics, pharmacokinetics, metabolism of the combination therapies for diabetic patients with hypertension{angiotension conversion enzyme inhibitor (ACEI)、β-Blocker 、 Calcium Channel Blocker、 Diuretic 、 ARB agent、α-Blocker}and dyslipidemia (HMG-CoA and Fibrate) are taken into considerations for the efficacy and efficiency of the medicines.
Angiotension conversion enzyme inhibitors are found to be the preferred treatment for diabetic complications like Nephropathy 、Macrovascular Complications and Retinopathy, not only for the lower incidence of the complications but also for the prevention effect. For patient with dyslipidemia, fibrates are found to be the first priority medication.

並列關鍵字

angiotension conversion enzyme inhibitor (ACEI) ； β-Blocker ； Calcium Channel Blocker ； Diuretic ； ARB agent ； α-Blocker

參考文獻

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