西格列汀、罗格列酮分别联合二甲双胍治疗老年2型糖尿病的疗效观察

Clinical Observation on Curative Effect of Sitagliptin, Rosiglitazone Combined with Metformin Respectively in Treatment of Elderly Type 2 Diabetes

目的:观察并对比二肽基肽酶-Ⅳ抑制剂西格列汀、胰岛素增敏剂罗格列酮分别联合降糖药物二甲双胍治疗老年2型糖尿病(T2DM)的临床疗效。方法:入选2010年4月-2012年10月间我科收治的老年T2DM患者70例,并随机单盲分为A(n=36)、B(n=34)两组,A组患者予西格列汀+二甲双胍方案,B组予罗格列酮+二甲双胍方案,服药12周后对比两组血糖水平、临床疗效并药物不良反应。结果:①两组患者服药12周后,血糖指标均较治疗前明显下降(P<0.05),A组患者2hPG水平明显低于B组水平(P<0.05)。②A组患者显效率(50.0%)、总体有效率(91.7%)略高于B组(38.2%、85.3%),差异不具有统计学意义(P>0.05)。③两组患者均未出现严重药物不良反应,两组不良反应发生率(19.4%vs.26.5%)无统计学差异(P>0.05)。结论:两种用药方案均是治疗老年T2DM的有效方案,西格列酮+二甲双胍方案较之罗格列酮+二甲双胍方案在临床疗效中具备比较优势,尤其是对降低餐后血糖优势明显。

Objective： To observe and compare the clinical efficacy between sitagliptin and the rosiglitazone combined with metformin respectively on the treatment of type 2 diabetes in elder patients. Methods：70 admitted cases from Apr.2010 to Oct. 2012 were randomized into A （n=36） ＆ B （n=34）group single blindly, group A was given sitagliptin plus mefformin schme,and group B was applied with rosiglitazone plus metformin schme, both were treated for 12 weeks, After which blood glucose level, clinical efficacy and adverse drug reaction during treatment were noted and compared between 2 groups. Results： （1）Glycemic indexes of 2 group patients after 12 weeks＇ therapy were lower than pre-treatment （P〈 0.05）, 2hPG level of group A was significantly lower than that of group B （P〈 0.05）. （2）Patients in group A with significant efficiency （50%）, overall efficiency （91.7%） was slightly higher than that of group B （38.2%, 85.3%）, the difference was not statistically significant （P〉0.05）. （3）There were no seriously adverse drug reactions in 2 groups, incidences of adverse reactions of 2 groups（19.4%vs.26.5%） showed no significant difference （P〉0.05）. Conclusion： Both 2 schemes are effective in treatment of elderly patients with type 2 diabetes mellitus, sitagliptin plus metformin scheme compared with rosiglitazone plus metformin scheme has a comparative advantage in clinical efficacy, and especially has obvious advantage in reducing postprandial blood glucose.