西格列汀联合二甲双胍治疗初诊2型糖尿病的疗效观察

Effect Observation on Sitagliptin Combined with Metformin in the Treatment of Incipient and Obese Type 2 Diabetes

目的探讨西格列汀联合二甲双胍治疗初发、肥胖2型糖尿病的临床疗效。方法选取2012年1月至2013年12月期间在我院治疗的180例初发、肥胖2型糖尿病患者为研究对象,将其随机分为治疗组和对照组,其中治疗组92例,对照组88例。对照组患者给予格列美脲+二甲双胍治疗,治疗组给予二甲双胍+西格列汀治疗。入组前常规进行肝肾功能、血糖血脂、糖化血红蛋白、胰岛细胞分泌功能、胰岛素抵抗等评估,治疗期24周。治疗结束后分析两组患者的在体重、空腹血糖、餐后2小时血糖、糖化血红蛋白、胰岛细胞分泌功能、胰岛素抵抗指数等方面的差异。结果治疗组患者各项监测指标(空腹及餐后血糖、糖化血红蛋白、胰岛细胞分泌功能、胰岛素抵抗指数)明显好于对照组患者(P<0.05),且治疗组的总有效率92.40%(85/92)和对照组患者72.73%(64/88)相比占优势,两组患者比较差异具有统计学意义(P<0.05)。两组患者在体重、低血糖发作方面无明显差异(P>0.05)。结论二甲双胍联合西格列汀治疗初发、肥胖2型糖尿病患者安全有效,值得借鉴。

Objective To investigate the clinical effect of sitagliptin combined with metformin in the treatment of incipient and obese type 2 diabetes. Methods 180 cases of patients with incipient and obese type 2 diabetes treated in our hospital from January 2012 to December 2013 were selected as objects. All the patients were randomly divided into treatment group （92 cases） and control group （88 cases）. The control group was given glimepiride combined with metformin for treating, while the treatment group received metformin combined with sitagliptin for treating. All the patients were evaluated hepatic and renal function, blood sugar and blood fat, glycosylated hemoglobin, secretion function of islet cell, insulin resistance. The treatment period was 24 weeks. After the treatment, the body weight, fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin, secretion function of islet cell, insulin resistance of two groups were analyzed and compared. Results The monitoring index （fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, secretion function of islet cell, insulin resistance） of the treatment group was significantly better than the control group, with statistical significant difference （P 〈0.05）. The total effective rate of the treatment group was 92.40% （85/92）, significantly higher than 72.73% （64/88）, with statistical significant difference （P〈0.05）. The body weight and the incidence of hypoglycemia of the two groups had no statistical significant difference （P 〉0.05）. Conclusions The application of sitagliptin combined with metformin in the treatment of incipient and obese type 2 diabetes can improve the clinical efficacy, significantly relieve adverse effects caused by patients＇ high blood glucose and increase the effective rate of medication, which is worth promoting.