西格列汀联合二甲双胍治疗2型糖尿病的临床观察

Clinical observation of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus

目的探讨西格列汀联合二甲双胍治疗2型糖尿病的疗效与安全性。方法选取100例2型糖尿病患者，按随机数字表法分为两组，每组50例，研究组采用磷酸西格列汀（100mg日1次口服）联合二甲双胍（500mg日3次口服）治疗，对照组采用瑞格列奈（1mg日3次口服）联合二甲双胍（500mg日3次口服）治疗，两组均治疗12周，治疗前后分别观察两组患者空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、体质量指数（BMI）及低血糖事件发生率等变化。结果两组治疗后FPG、2hPG、HbA1C均较治疗前显著下降，差异有统计学意义（P〈0．01）。研究组治疗后BMI显著减低[（24．45±2．13）kg／m2比（25．46±2．62）kg／m2]，FINS显著升高[（13．36．4±1.89）mU／L比（12．36±1．80）mU/L]，与治疗前比较差异有统计学意义（P〈0．05或〈0．01）。对照组治疗后BMI、FINS与治疗前比较差异无统计学意义（P〉0．05）。研究组和对照组低血糖事件发生率比较差异有统计学意义[0比12％（6／50）]（P〈0．05）。结论西格列汀联合二甲双胍治疗2型糖尿病的方案是安全有效的，不仅能显著减少低血糖事件的风险，而且具有能控制并减轻体质量等优越性，是治疗2型糖尿病的优选方案。

Objective To discuss the efficacy and safety of sitagliptin combined with mefformin in treatment of type 2 diabetes mellitus（T2DM）. Methods One hundred patients with T2DM were divided into two groups by random digits table method with 50 cases each. The patients in study group were given phosphate sitagliptin （ 100 mg,day 1 oral） combined with mefformin （500 mg,day 3 oral）. The patients in control group were given repaglinide （ 1 mg,day 3 oral） combined with metformin （500 mg, day 3 oral）. They were treated for 12 weeks and fasting plasma glucose（FPG）,2 h postprandial blood glucose（2 h PG）, glycosylated hemoglobin （HbA1c）,fasting insulin （FINS）, body mass index （BMI） and the incidence of hypoglycemic events were detected before and after treatment. Results After treatment, the level of FPG, 2 h PG, HbA1c was significantly lower than that before treatment in two groups,and there was significant difference （P 〈 0.01 ）. The level of B MI after treatment was significantly decreased [ （24.45 ± 2.13 ） kg/m2 vs. （25.46±2.62） kg/m2] and FINS was significantly increased [（13.36± 1.89） mU/L vs. （12.36 ± 1.80） mU/L] compared with that before treatment in study group （P 〈 0.05 or 〈 0.01 ）. But the level of BMI and FINS had no significant difference before and after treatment in control group （P 〉 0.05 ）. The incidence of hypoglycemic events had significant difference between study group and control group [0 vs. 12%（6/50）] （P 〈 0.05 ）. Conclusions Sitagliptin combined with mefformin is safe and effective in treatment of type 2 diabetes mellitus, which is the preferred solution treatment. The risk of hypoglycaemia events is obviously reduced, also it can control and reduce weight and other advantages.