利拉鲁肽联合二甲双胍治疗初诊肥胖2型糖尿病的临床效果分析

The analysis of the clinical effect of liraglutide combined with metformin on the treatment of initial diagnosis of type 2 diabetes with obesity

目的探究利拉鲁肽联合二甲双胍对初诊肥胖2型糖尿病的治疗效果。方法筛选2012年3月-2013年6月间于我院内分泌门诊诊断的72例初诊肥胖2型糖尿病患者作为研究对象，通过随机编号的方法将其分为观察组和对照组，每组各36例，其中观察组采取二甲双胍联合利拉鲁肽用药，对照组则采取二甲双胍单独药物治疗。详细记录并分析两组患者的空腹血糖、餐后2h血糖、体重指数、腰围及低血糖发生率等指标变化情况。结果经过16周的治疗，两组患者的病情均得到有效控制，治疗前后比较有显著差异（P〈0．05）；观察组患者的空腹血糖、餐后2h血糖及体重指数等指标均显著优于对照组，组间比较差异有统计学意义（P〈0．05）；观察组患者的腰围虽相对缩小明显，但组间比较差异无统计学意义（P〉0．05）；观察组出现低血糖的患者为2例，对照组为9例，不良反应发生率组间对比有显著差异（P〈0．05）。结论利拉鲁肽联合二甲双胍治疗初诊肥胖2型糖尿病，具有降低患者体重、缩小腰围、改善BMI指数和有效降低空腹血糖等优势，在减少不良反应发生率的同时提升患者的耐受性，值得在临床中推广应用。

Objective To explore the clinical effect of liraglutide combined with metformin on the initially diagnosed obesity type 2 diabetes. Methods There were 72 patients with obesity type 2 diabetes who were newly diagnosed in the Endocrinology Department from March 2012 to June 2013. They were divided into observation group and control group randomly, with 36 cases in each group. The observation group was supplied with liraglutide in combination with metformin, while the control group was provided with metformin only for treatment. The changes of indexes such as the FBG（fasting blood-glucose）, 2hPBG（two hours postprandial blood glucose）, BMI（body mass index）, waist circumfer- ence,incidence of hypoglycemia of the two groups of patients before and after treatment were detailedly recorded and analyzed. Results After 16-week treatment, the patients＇ condition in both groups were effectively controlled, with distinction in contrast before and after the treatment. The indexes such as FPG,2hPPG and BMI of observation groups were remarkably superior to those of control group, thus making the contrast differences between groups meaningful in statistics（P〈0.05）. However,although the waist size of patients in observation group had prominently fallen compared to that of control group, the contrast differences between the two groups remains meaningless in statistics（P〉0.05）. There were 2 cases of hypoglycemia appearing in observation group while there are 9 in control group,which the difference of adverse reaction rate between the two groups was significant（P〈0.05）. Conclusion The therapy of liraglutide combined with mefformin on the initially diagnosed obesity type 2 diabetes has brought out lower weight,narrowed waistline, improved BMI, declined FBG, etc. meanwhile,the combined therapy may enhance the tolerance while reduce the inci- dence of adverse reactions,thus deserving the population and application in clinical medincine.