格列齐特联合利格列汀治疗2型糖尿病的临床研究

Clinical study on gliclazide combined with linagliptin in treatment of type 2 diabetes mellitus

目的探讨格列齐特缓释片联合利格列汀片治疗2型糖尿病的临床疗效。方法选取2015年6月—2017年4月天津医科大学第二医院内分泌科收治的2型糖尿病患者120例为研究对象,根据随机原则分成对照组和治疗组,每组各60例。对照组口服利格列汀片,5 mg/次,1次/d。治疗组在对照组基础上口服格列齐特缓释片,30 mg/次,1次/d。两组患者均连续治疗12周。观察两组的临床疗效,比较两组的血糖水平、糖化血红蛋白(Hb A1c)、胰岛素抵抗指数(HOMA-IR)和稳态模型评估β细胞功能(HOMA-β)。结果治疗后,对照组和治疗组的总有效率分别为83.33%、96.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组空腹血糖、餐后2 h血糖和Hb A1c水平均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组空腹血糖和Hb A1c水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组HOMA-IR显著下降,HOMA-β显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组HOMA-β明显高于对照组,两组比较差异具有统计学意义(P<0.05)。结论格列齐特缓释片联合利格列汀片治疗2型糖尿病具有较好的临床疗效,可改善胰岛素抵抗和胰岛β细胞功能,安全性较好,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Gliclazide Modified Release Tablets combined with Linagliptin Tablets in treatment of type 2 diabetes mellitus. Methods Patients（120 cases） with type 2 diabetes mellitus in the Second Hospital of Tianjin Medical University from June 2015 to April 2017 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Linagliptin Tablets, 5 mg/time, once daily. Patients in the treatment group were po administered with Gliclazide Modified Release Tablets on the basis of the control group, 30 mg/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and blood glucose levels, Hb A1 c, HOMA-IR and HOMA-β in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.33% and 96.67%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of fasting blood glucose, postprandial 2 h blood glucose, and Hb A1 c in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the levels of fasting blood glucose and Hb A1 c in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the HOMA-IR in two groups was significantly decreased, but the HOMA-β in two groups was significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the HOMA-β in the treatment group was significantly higher than that in the control group, with significant difference between two groups（P〈0.05）. Conclusion Gliclazide Modified Release Tablets combined with Linagliptin Tablets has clinical curative effect in treatment of type 2 diabetes mellitus, can improve insulin resistance and beta cell function, with good safety, which has a certain clinical application value.