吡格列酮二甲双胍片复合制剂与单用两药治疗2型糖尿病对血糖、胰岛素抵抗、血脂代谢影响及不良反应

The Effect and Adverse Reactions of the Single Treatment or Compound Preparation of Pioglitazone and Metformin on Blood Glucose,Insulin Resistance,Blood Lipid Metabolism for Type 2 Diabetes Mellitus

目的观察吡格列酮二甲双胍片复合制剂与吡格列酮或者二甲双胍片在2型糖尿病治疗中对血糖、胰岛素抵抗、血脂代谢影响及不良反应。方法按治疗方式随机选择2014年2月—2017年2月收治的2型糖尿病患者138例,分为3组各46例,A组予以吡格列酮治疗,B组予以二甲双胍治疗,复合组予以吡格列酮二甲双胍片复合制剂组治疗。比较各组临床疗效、血糖、胰岛素抵抗指标、血脂及不良反应。结果复合组总有效率高于A组和B组,比较有统计学差异(P<0.05),A组和B组总有效率比较无统计学差异(P>0.05)。治疗后,各组血糖指标、胰岛素指标、甘油三脂(TG)、低密度脂蛋白-C(LDL-C)均较治疗前下降,复合组显著低于A组和B组,比较有统计学差异(P<0.05),A组和B组比较无统计学差异(P>0.05)。各组高密度脂蛋白C(HDL-C)均较治疗前上升,复合组明显高于A组和B组,比较有统计学差异(P<0.05),A组和B组比较无统计学差异(P>0.05)。各组均有胃肠道不适、水肿、乏力、发热发生,但不良反应发生率比较无统计学差异(P>0.05)。结论 2型糖尿病患者单用吡格列酮或者二甲双胍片均可起到相似的临床效果,但吡格列酮二甲双胍片复合制剂的临床疗效明显优于单用两药,能更有效地改善血糖、胰岛素抵抗、血脂代谢,且不良反应少。

Objective To comparative research of pioglitazone mefformin tablets composite preparation with two drugs alone on blood glucose, insulin resistance, lipid metabolism and adverse reactions in the treatment Type 2 diabetes mellitus. Methods According to the treatment method, 138 patients with type 2 diabetes were randomly selected from February 2014 to ebruary 2017 and divided into 3 groups （46 cases each）. Group A was treated with pioglitazone, group B was treated with metformin, and compound group was treated with pioglitazone metformin tablets. Clinical efficacy, blood glucose, insulin resistance, blood lipid, and adverse reactions between various groups were compared. Results Total effective rate of the composite group was higher than that group A and group B, and there was a statistically significant difference （ P 〈 0. 05 ） , and total effective rate of group A and group B was no difference （ P 〉 0.05 ）. After treatment, the blood sugar, insulin, tri- glycerides （TG）, low density lipoprotein cholesterol （LDL） - C of various groups was decreased, the compound group was significantly lower than group A and group B, and there was statistically significant differences （P 〈 0. 05）. Group A and group B was no difference （P 〉 0.05）. High density lipoprotein C （ HDL - C） in each group was higher than before treatment, and the composite group was significantly higher than group A and group B, and there was a statistically significant difference （P 〈 0. 05）, and there was no difference between group A and group B （P 〉 0. 05）. All groups had gastrointestinal discomfort, edema, fatigue and fever, but there was no difference in the incidence of adverse reactions between various groups （P 〉 0.05）. Conclusion Patients with type 2 diabetes may have similar clinical effects with pioglitazone or metformin tablets, clinical effect of pioglitazone metformin tablets composite preparation is better than two drugs alone, can improve blood glucose, insulin resistance and blood lipid metabolism, and less adverse reactions.