吡格列酮联合胰岛素治疗2型糖尿病疗效观察

Observation of the Curative Effect of Pioglitazone Combined With Insulin for Type 2 Diabetes

目的观察吡格列酮联合胰岛素治疗2型糖尿病的临床疗效。方法挑选32例我院新诊断2型糖尿病患者将其随机分成A组和B组,每组各16例患者。A组采用胰岛素治疗法,B组在A组的基础上联合吡格列酮(瑞彤)30 mg/d用药。A组和B组进行为期4周的治疗并进行观察。结果经过4周治疗,A组患者的血糖达标时间、达标时胰岛素日用量、胰岛素抵抗指数分别为(14.3±2.6)、(45.7±4.8)、(7.6±1.5),B组患者的血糖达标时间、达标时胰岛素日用量、胰岛素抵抗指数分别为(7.2±1.6)、(34.6±3.4)、(5.1±1.1),与治疗前相比,两组患者空腹血糖、餐后2小时血糖、糖化血红蛋白均下降明显,差异具有统计学意义(P<0.05),但体重与治疗前相比无明显变化。两组患者治疗后胰岛素抵抗指数下降明显,且B组上述指标改善情况优于A组,组间差异存在统计学意义(P<0.05)。结论吡格列酮联合胰岛素治疗2型糖尿病疗效确切,同时可以改善胰岛B细胞功能,降低胰岛素抵抗,增加胰岛素敏感性,减少胰岛素用量,二者起协同作用,优于单纯胰岛素治疗。

Objective To observe the clinical efficacy of pioglitazone combined with insulin in treatment of type 2 diabetes. Methods 32 cases of patients who were newly diagnosed type 2 diabetes were selected and were randomly divided into A group and B group, 16 cases in each group. The patients in A group were treated with insulin plus. And the patient of B group, on the basis of A group, were treated with pioglitazone（ Rui Tong） 30 mg/d. A group and B group were making the treatment for 4 weeks and were observed. Results After 4 weeks of treatment, blood glucose of patients, the standard daily dose of insulin and insulin resistance index in group A were（14.3 ± 2.6）,（45.7 ± 4.8）,（7.6 ± 1.5）, blood glucose of patients, the standard daily dose of insulin, insulin resistance index in group B were（7.2±1.6）,（34.6±3.4）,（5.1±1.1）. Compared with before the treatment, fasting blood glucose, postprandial two hours blood glucose and glycated hemoglobin of 2 groups of patients significantly decreased, the difference was statistically significant（P〈0.05）, but there is no significant change in weight compared with before therapy. The index of insulin resistance of two groups after the treatment decreased significantly, and the level of improvement of the above indexes in group B was significantly better than in group A, The difference between two groups was statistically significant（P〈0.05）. Conclusion Treating type 2 diabetes with pioglitazone combined with insulin is effective, can improve islet B cell function, reduce insulin resistance, increase insulin sensitivity and reduce the amount of insulin, both of which act synergistically were better than insulin therapy.