西格列汀联合二甲双胍治疗肥胖2型糖尿病患者的疗效分析

Clinical research of sitagliptin combined with metformin for treating obese patients with type 2 diabetes

目的探讨西格列汀联合二甲双胍治疗肥胖2型糖尿病患者并控制血糖的临床疗效。方法筛选86例肥胖2型兼血糖控制不佳的新诊断的糖尿病患者。随机分为两组,两组患者均进行糖尿病饮食控制和适量运动。在此基础上,对照组患者采用阿卡波糖联合二甲双胍治疗;治疗组患者采用西格列汀联合二甲双胍治疗,治疗时间均为12周,分别于治疗前后检测两组患者糖基化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、体重指数(BMI)以及胰岛β细胞功能指数(HOMA-β)等指标。结果治疗组治疗后FPG、2 h FPG、HbA1c、BMI与对照组治疗后比较,差异均有统计学意义(t分别=13.73、6.57、13.17、59.53,P均<0.05),而HOMA-β比较差异无统计学意义(t=1.10,P>0.05);且治疗组治疗后TC、TG、LDL-C、HDL-C与对照组治疗后比较,差异均有统计学意义(t分别=12.26、7.75、4.73、4.03,P均<0.05)。结论西格列汀联合二甲双胍能有效降低血糖血脂,并控制患者体重,是针对2型糖尿病肥胖患者的有效治疗方案。

Objective To investigate the clinical effect of sitagliptin combined with metformin for treating obese patients with type 2 diabetes. Methods A total of 86 cases of obesity, poor glycemic controlling and newly diagnosed type 2 diabetes patients were randomly divided into two groups. The patients of two groups were given diabetic diet and took regular exercise. In addition, the control group were treated with acarbose combined with metformin while the treatment group were treated with sitagliptincombined with metformin for 12 weeks. The glycosylated hemoglobin （HbA1c）, fasting plasma glucose （FPG）, 2 hours postprandial blood glucose （2 h FPG）, triglycerides （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, body mass index （BMI） and pancreatic β-cell function index （HOMA-β） were detected. Results The FPG, 2 h FPG, HbA1c and BMI of the treatment group after treatment were significantly lower than those of the control group （t=13.73,6.57,13.17,59.53,P〉0.05） while the difference of HOMA-β was not statistically significant （t=1.10,P〈0.05）. The differences of TC, TG, LDL-C and HDL-C after treatment between the treatment group and control group were statistically significant （t=12.26, 7.75, 4.73, 4.03, P〉0.05）. Conclusion Sitagliptin combined with metformin can effectively reduce blood glucose and lipid and control weight. It is an effective treatment for obese patients with type 2 diabetes.