达格列净联合二甲双胍治疗2型糖尿病的临床观察

Clinical Observation of the Treatment of Type 2 Diabetes Mellitus with the Combination of Dapagliflozin and Metformin

目的探讨达格列净联合二甲双胍治疗2型糖尿病临床效果,总结达格列净临床药效。方法收治2016年1月至2017年4月期间,入我院单纯服用二甲双胍医治效果不理想的患者84例作为探究对象,将这84例患者自由的分为A(二甲双胍治疗)、B(达格列净+二甲双胍治疗)两组,每组42例。观察、检测并记录两组患者的体质量指数、空腹血糖、餐后2 h血糖、糖化血红蛋白、尿酸、血清总胆固醇、三酰甘油、低密度胆固醇的含量,并对比前后两组患者的各项指标变化情况,并对比两组患者治疗期间的不良反应发生概率,患者对治疗的满意程度。结果治疗结束之后,两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均比医治前有所下降,但B组患者的以上三项指标下降的幅度较A组的大,P<0.05。治疗前后两组患者的血清总胆固醇和低密度胆固醇没有太大的差异,但是B组患者的体质量指数、尿酸、三酰甘油下降幅度较大,与治之前对比,P<0.05;A、B两组治疗后的尿酸、三酰甘油差异不明显,P>0.05,但A、B组患者的体质量指数相比,差异较大,P<0.05。A、B组患者治后都没有比较严重的低血糖反应,A组患者发生腹泻1例(2.4%),B组患者发生下尿路感染1例(2.4%),后用抗菌药物治疗痊愈,A组不良反应发生概率为2.4%,B组不良反应发生概率为2.4%,即两组患者的不良反应发生概率没有差异,P>0.05。B组患者治疗后患者对医治效果的满意人数为42例,满意度为100%,比A组(24例/57.14%)明显的高,具有很大的差异,P<0.05。结论达格列净结合二甲双胍一起服用,能够有效的降低患者的血糖、体质量指数,患者对治疗的满意度达到100%,期间出现的不良反应很少,仅为2.4%,切可治愈,达格列净+二甲双胍一同治疗2型糖尿病有较高的疗效,值得被广泛应用。

Objective To explore the clinical effect of dapagliflozin combined with metformin in the treatment of type 2 diabetes, and to summarize the clinical efficacy of dapagliflozin. Methods in the period of January 2016-April 2017, 84 patients who were treated with metformin in our hospital were divided into two groups： A（metformin treatment） and B（dapagliflozin＋metformin）, and 42 cases in each group. The body mass index, fasting blood glucose, postprandial 2 H blood sugar, glycated hemoglobin, uric acid, serum total cholesterol, three acylglycerol, low density cholesterol in two groups of patients were observed and recorded, and the changes in the indexes of the two groups were compared, and the incidence of adverse reactions during the treatment of the two groups was compared. The degree of satisfaction of the patient to the treatment. Results After the treatment, the fasting blood glucose, postprandial 2 hours blood sugar and glycated hemoglobin in the two groups were lower than those before treatment, but the above three indexes in the B group were significantly lower than those in the group A, P0.05. There was no significant difference in serum total cholesterol and low density cholesterol in the two groups of patients before and after treatment, but the body mass index, uric acid and three acyl glycerol in the B group were significantly lower than those before treatment. The difference of uric acid and three glycerol after treatment in group P 0.05, A and B two groups was not obvious, P 0.05, but the body mass index in group A and B patients. In comparison, the difference is larger, P 0.05. The patients in group A and group B had no severe hypoglycemic reaction, 1 cases（2.4%） had diarrhea in group A, 1 cases of lower urinary tract infection（2.4%） in group B, after treatment with antibiotics, the probability of adverse reaction in group A was 2.4%, and the incidence of adverse reaction in group B was 2.4%, that is, the adverse reaction occurred in two groups of patients. There is no difference in rate, P 0.05. The number of patients satisfied with treatment after treatment in group B was 42, the satisfaction was 100%, which was significantly higher than that of group A（24 cases/57.14%）, with a great difference, P0.05. Conclusion Dapagliflozin combined with metformin can effectively reduce the blood sugar and body mass index of the patient. The patient＇s satisfaction to the treatment is 100%, and the adverse reaction in the period is very few. It is only 2.4%. It can be cured. It has a high curative effect in treating type 2 diabetes with dapagliflozin＋ metformin. It is worth being widely used. Application.