二甲双胍联合西格列汀对初诊T2DM患者临床疗效分析

Clinical analysis of metformin combined with western medicine in the treatment of newly diagnosed T2DM patients

目的分析二甲双胍联合西格列汀对初诊2型糖尿病(T2DM)患者临床治疗效果。方法选取2014年11月—2016年12月在河南科技大学第一附属医院接受治疗T2DM患者128例,采用随机法分为对照组(n=60)和联合组(n=68)。对照组患者在常规低糖饮食和运动辅助治疗下给予二甲双胍治疗,联合组患者在对照组基础上加用西格列汀治疗。两组疗程均为6个月。观察并比较两组患者疗效、血糖、血脂、炎症因子、肝功水平及不良反应情况。结果联合组患者治疗后总有效率为92.65%,显著高于对照组的71.67%,差异有统计学意义(P<0.05)。两组患者治疗前体质指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、血浆C肽(FCP)、糖化血红蛋白(Hb A1c)比较无统计学差异;两组患者治疗后BMI、FPG、2h PG水平及Hb A1c均较治疗前下降,且联合组患者BMI、FPG、2h PG水平及Hb A1c低于对照组患者,差异有统计学意义(P<0.05)。两组患者治疗前肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平比较无统计学差异;联合组患者治疗后TNF-α、IL-6及IL-8水平均低于治疗前和对照组治疗后患者,差异有统计学意义(P<0.05);对照组患者治疗前后TNF-α、IL-6及IL-8水平比较无统计学差异。两组患者治疗前后胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及血肌酐(Scr)水平比较,差异无统计学意义。联合组患者消化系统不良反应率低于对照组患者,差异有统计学意义(P<0.05)。结论二甲双胍联合西格列汀治疗初诊2型糖尿病疗效显著,可控制血糖和炎症因子水平,且不影响肝功能水平,不良反应小,安全性高。

Objective To analyze the clinical effect of metformin combined with western medicine in the treatment of newly diagnosed type 2 diabetes mellitus （T2DM）. Methods 128 patients with T2DM who were treated in our hospital from November 2014 to December 2016 were randomly divided into control group （n = 60） and combination group （n = 68）.The patients in the control group were given metformin treatment with conventional low sugar diet and exercise therapy, and the patients in the combined group were treated with Sig Leo Dean on the basis of the control group. The two groups were observed and compared the curative effect, blood glucose, blood lipid, inflammatory factors, liver function and adverse reactions. Results The patients treated with the combined group were treated with 49 cases, 14 of which were effective, and the total effective rate was 92.65% higher than those in the control group, and the difference was statistically significant （P 〈 0.05）. There was no significant difference in BMI, FPG, 2hPG, FCP and HbAlc before treatment between the two groups. After treatment, BMI, FPG, 2hPG and HbAlc were decreased in all two groups, and the levels of BMI, FPG, 2hPG and HbAlc in the combined group were lower than those in the control group （P 〈 0.05）. There was no significant difference in the levels of TNF-α, IL-6 and IL-8 before treatment between the two groups. After treatment, TNF-α, IL-6 and IL-8 in the combined group were lower than those before treatment and control group （P 〈 0.05）. The levels of TNF-α, IL-6 and IL-8 were not significantly different between the control group and the control group. Two groups of patients before and after treatment TC, LDL-C, HDL-C, ALT, AST, BUN and Scr levels, the difference was not statistically significant.The adverse reaction rate of digestive system in the combined group was lower than that in the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Metformin combined with western medicine in the treatment of newly diagnosed type 2 diabetes has a significant effect, can control the level of blood glucose and inflammatory factors, and does not affect the level of liver function, adverse reactions, high safety.