维格列汀联合伏格列波糖治疗老年初诊2型糖尿病患者的效果观察

Observation on Therapeutic Effect of Vildagliptin Combined with Voglibose on Elderly Patients with Newly Diagnosed Type 2 Diabetes Mellitus

目的:探究维格列汀、伏格列波糖联合治疗老年初诊2型糖尿病患者的临床效果。方法:选取我院2016年8月—2018年4月收治的老年初诊2型糖尿病患者104例,按随机数字表法分为对照组与观察组,各52例。对照组给予维格列汀(50 mg,bid)治疗,观察组给予维格列汀(同对照组)、伏格列波糖(0.2 mg,tid)联合治疗。比较两组动态血糖监测指(MAGE)、治疗后24 h平均血糖(MBG)、血糖达标时间、不良反应发生情况及治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-IS)、血清高糖素样多肽(GLP)-1与胰岛素(INS)水平、血清炎症因子[肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、C反应蛋白(CRP)]水平。结果:治疗后两组FPG、2 hPG、HbA1c低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后观察组HOMA-IR低于对照组,HOMA-IS高于对照组,差异有统计学意义(P<0.05);治疗后观察组血清INS水平低于对照组,血清GLP-1水平高于对照组,差异有统计学意义(P<0.05);观察组MAGE低于对照组,MBG高于对照组,血糖达标时间短于对照组,差异有统计学意义(P<0.05);治疗后两组血清TNF-α、IL-6、CRP水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:维格列汀、伏格列波糖联合治疗老年初诊2型糖尿病,可改善患者的胰岛功能,缓解炎症反应,促进血糖平稳达标,且安全性高。

Objective:To explore the clinical effect of vildagliptin and voglibose on elderly patients with newly diagnosed type 2 diabetes mellitus.Methods:104 patients with newly diagnosed type 2 diabetes mellitus admitted to our hospital from August 2016 to April 2018 were selected and randomly divided them into a control group and an observation group,52 cases each.The patients in the control group were treated with vildagliptin(50 mg,bid),and the patients in the observation group were treated with vildagliptin combined with voglibose(0.2 mg,tid).The dynamic blood glucose monitoring index(MAGE),mean blood glucose(MBG)24 hours after treatment,the time of blood glucose reaching the standard,adverse reactions,blood glucose indexes before and after treatment[fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),glycated hemoglobin(HbA1 c)],insulin resistance index(HOMA-IR),insulin secretion index(HOMA-IS),serum high-glycosin-like polypeptide(GLP)-1,insulin(INS)level and serum inflammatory factor[tumor necrosis factor(TNF)-α,interleukin(IL)-6,C-reactive protein(CRP)]levels were compared between the two groups.Results:The levels of FPG,2 hPG and HbA1 c after treatment were lower than those before treatment in the two groups,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the HOMAIR in the observation group was lower than that in the control group,while,while the HOMA-IS was higher than that in the control group,with statistically significant differences(P<0.05).After treatment,the serum INS level in the observation group was lower than that in the control group,while the serum GLP-1 level was higher than that in the control group,with statistically significant differences(P<0.05).The MAGE in the observation group was lower than that in the control group,while the MBG was higher than that in the control group,and the time of blood glucose reaching the standard was shorter than that in the control group,with statistically significant differences(P<0.05).The levels of serum TNF-α,IL-6 and CRP after treatment were lower than those before treatment in the two groups,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Vildagliptin combined with voglibose used in treating newly diagnosed type 2 diabetes mellitus in elderly patients can improve the islet function of the patients,alleviate the inflammatory response and promote blood glucose to reach the standard smoothly,and has high safety.