盐酸吡格列酮联合二甲双胍治疗2型糖尿病的疗效观察

Observation on the effect of pioglitazone hydrochloride combined with Metformin on type 2 diabetes

目的观察盐酸吡格列酮联合二甲双胍治疗2型糖尿病(T2DM)患者的疗效和安全性。方法将单用二甲双胍0.75g/d治疗2个月以上血糖控制欠佳的T2DM患者76例随机分成试验组39例及对照组37例,试验组加用盐酸吡格列酮30mg/d,对照组将二甲双胍剂量加至1.5g/d,连续治疗6个月,观察治疗前后血糖、糖化血红蛋白(HbA1c),稳态模型胰岛素抵抗(HomaIR)指数,血脂、体重指数(BMI)的变化。结果试验组和对照组治疗后血糖、HbA1c、HomaIR均较治疗前明显下降,血脂代谢得到改善,且有统计学意义。试验组的餐后血糖、HbA1c、HomaIR及血脂改善优于对照组。对照组BMI较治疗前下降,试验组没有明显变化。结论吡格列酮30mg/d联合二甲双胍0.75g/d对2型糖尿病患者的糖脂代谢及胰岛素抵抗的改善优于单用二甲双胍1.5g/d。

Objective To observe the effiacy and safety of pioglitazone combined with mefformin in treatment of type 2 diabetic patients. Methods There 76 patients on a stable regimen of mefformin 0.75g/day for 〉 or = 2 months and with poor glycaemic control were selected and divided randomly into observation group treated with pioglitazone 30mg/day and mefformin 0.75g/day orally given for 6 months and control group treated with mefformin 1 .5g/day for a course of 6 months. The levels of plasma glucose, HbAlc HomaIR, lipid profiles and BMI were determined before and after the treatment in two groups. Results After treatment, the levels of plasma glucose, HbAlc, HomaIR were decreased and the lipid profiles were improved significantly in two group. Meanwhile, 2hPG, HbAlc, HomalR and lipid profiles in the observation group were improved more better than that in control group, and BMI were decreased in control group without significant differences. Conclusion The effect of pioglitazone with he dose of 30mg/day and mefformin 0.75g/day is better than tha of mefformin with the dose of 1.5g/day in improvement of metabolism of glucose and lipid and insulin resistance in patients with type 2 diabetes mellitus.