吡格列酮和二甲双胍治疗2型糖尿病的对照研究

The Effects of Pioglitazone Compared with Metformin on Diabetes Mellitus II by Parallel Double-blind Randomized Control Clinical Trial

目的 :评价吡格列酮和二甲双胍片降糖、调脂及改善胰岛素敏感作用。方法:采用平行双盲随机对照研究两药的作用。结果 :(1)吡格列酮组试验后空腹和餐后2h血糖、糖化血红蛋白 (HbA1c)、空腹胰岛素和C -肽、餐后2h胰岛素和C -肽、甘油三酯 (TG)和自由脂肪酸(FFA)、血尿酸和血压均较试验前下降 (P<0.05或P<0.01) ,高密度脂蛋白 -胆固醇 (HDL -C)较试验前升高 (P<0.01)。二甲双胍组试验后空腹和餐后2h血糖、HbA 1c、餐后2h胰岛素、TG、FFA、胆固醇 (TC)低密度脂蛋白 -胆固醇 (LDL -C)较试验前明显下降 (P<0.05或P<0.01)。HDL -C较试验前升高 (P<0.01)。(2)吡格列酮组试验后空腹、餐后2h胰岛素和C -肽均低于二甲双胍组 (P<0.05或P<0.01)。二甲双胍组TC与LDL -C低于吡格列酮组 (P<0.05)。(3)两种药物不良反应差别无统计学意义 (P>0.05)。结论 :两药有相似的降糖和调脂作用 ,而吡格列酮还能增加胰岛素敏感性 ,降低血尿酸。

Objective:To compare the effect of pioglitazone and metformin on glycemia,lipidemia and inˉsulin resistance in patients with type2diabetes.Methods:Clinical trial was used by parallel double blind ranˉdomized control.Results:(1)The index such as fasting glucose,2-hour glucose,glycation hemoglobin(HBA 1 c),fasting insulin,postprandial insulin,fasting c-peptide,postprandial c-peptide,triglycerides(TG),free fat acid(FFA),and uric acid in pioglitazone group were significantly reduced after3months(P<0.05or P<0.01).In metformin group,all index decreased compared to that before the treatment(P<0.05or P<0.01),and HDL-C increased(P<0.01).(2)In pioglitazone group,fasting insulin,postprandial insulin,fasting c-peptide and postprandial c-peptide were lower than that in metformin group(P<0.05or P<0.01).(3)There was no difference in side effects between two groups.Conclusion:Pioglitazone and metformin are equally efficasious to the control of glucose,free fat acid and triglycerides.Pioglitazone exerts significantly efˉfects on insulin sensitivity and decreases uric acid.