二甲双胍维格列汀片治疗2型糖尿病合并非酒精性脂肪肝的临床研究

Combination of metformin and vildagliptin in treating type 2 diabetes mellitus patients with non-alcoholic fatty liver disease

目的观察二甲双胍维格列汀片治疗2型糖尿病合并非酒精性脂肪肝(NAFLD)患者的临床疗效和安全性。方法将我院收治的70例2型糖尿病合并NAFLD患者,随机分为试验组和对照组,每组35例,对照组口服二甲双胍片治疗,试验组口服二甲双胍维格列汀片治疗,疗程均为12周,观察2组患者谷丙转氨酶(GPT)、谷草转氨酶(GOT)、γ-谷氨酰转肽酶(GGT)、血脂、空腹血糖(FPG)、糖化血红蛋白(HbA1C)和肝脏彩超等指标的变化。结果治疗后,试验组和对照组的总有效率分别为65.71%(23例/35例)和28.57%(10例/35例),差异有统计学意义(P<0.05)。试验组和对照组的GGT分别为(25.33±9.15)和(39.32±14.78)U·L^-1,FPG分别为(7.02±1.04)和(8.43±2.05)mmol·L^-1,HbA1C分别为(6.52±0.53)%和(7.36±1.05)%,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为14.29%(5例/35例)和8.57%(3例/35例),差异无统计学意义(P>0.05)。结论二甲双胍维格列汀片能够有效控制血糖,改善NAFLD,安全性较高。

Objective To observe the clinical curative effect and safety of metformin and vildagliptin compound preparation on type 2 diabetes mellitus patients with non-alcoholic fatty liver(NAFLD)disease.Methods Seventy type 2 diabetes mellitus patients with NAFLD admitted to our hospital were assigned to two groups:the control group(n=35)and the treatment group(n=35).The control group received metformin,the treatment group took metformin and vildagliptin compound preparation.The level of glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT),γ-glutamyl transpeptidase(GGT),lipids fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1C)and ultrasonograghy of liver were observed before and after 12 weeks of treatment.Results After treatment,the total effective rates of test and control group were 65.71%(23 cases/35 cases)and 28.57%(10 cases/35 cases),the difference was significant(P<0.05).There were statistically significant differences between the treatment group and the control group in GGT[(25.33±9.15)U·L^-1 vs(39.32±14.78)U·L^-1],FPG[(7.02±1.04)mmol·L^-1 vs(8.43±2.05)mmol·L^-1],HbA1C[(6.52±0.53)%vs(7.36±1.05)%](P<0.05).The incidences of adverse drug reactions in the treatment group and the control group were 14.29%(5 cases/35 cases)and 8.57%(3 cases/35 cases),respectively,and there was no statistically significant difference(P>0.05).Conclusion Metformin and vildagliptin compound preparation can effectively control glucose,and alleviate NAFLD with high safety.