对二甲双胍单药控制欠佳的2型糖尿病患者加用维格列汀的疗效观察

Efficacy of Metformin combined with Vildagliptin in type 2 diabetic patients failed with Metformin monotherapy

目的观察维格列汀联合二甲双胍治疗二甲双胍单药治疗效果欠佳的T2DM患者疗效。方法选取我院内分泌科收治的二甲双胍单药治疗效果欠佳的T2DM患者74例,随机分为二甲双胍+维格列汀组(Vil组)和二甲双胍+阿卡波糖组(Aca组),每组各37例,均观察12周。比较两组干预前后FPG、2 hPG、HbA1c、TC、TG、LDL-C、BMI、FIns、FC-P、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞相关指数(HOMA-β)及不良反应发生率。结果 12周后,Vil组HbA1c、FPG、2 hPG、TC、TG、LDL-C、BMI、HOMA-IR较干预前降低(P<0. 05),且较Aca组降低(P<0. 05);FIns、FC-P、HOMA-β较干预前及Aca组均升高(P<0. 05)。Vil组总不良反应发生率降低(P<0. 05)。结论对二甲双胍单药治疗效果欠佳的T2DM患者,二甲双胍联合维格列汀可更好地控制血糖,改善血脂、胰岛功能及减少胃肠道不适的发生。

Objective To observe the efficacy of Vildagliptin combined with Metformin in the treatment of patients with type 2 diabetes mellitus(T2 DM)who failed with Metformin monotherapy.Methods74 T2 DM patients poorly controlled with Metformin monotherapy were randomly divided into Metformin+Vildagliptin group(Vil,n=37)and Metformin+Acarbose group(Aca,n=37). After 3 months of treatment,the levels of FPG,PPG,HbA1 c,TC,TG,LDL-C,BMI,FIns,FC-P,HOMA-IR,HOMA-β and the incidence of adverse reactions were compared between two groups.ResultsAfter 3 months of combined treatment,the levels of HbA1 c,FPG,2 h PG,TC,TG,LDL-C,BMI and HOMA-IR were decreased in Vil group(P<0. 05),and the decrease was greater than that of Aca group(P<0. 05). The levels of FIns,FC-P and HOMA-β were increased,and the increase was greater than that of Aca group(P<0. 05). The incidence of adverse reactions was lower in Vil group(P<0. 05).ConclusionIn T2 DM patients who failed with Metformin monotherapy,the treatment combined with Vildagliptin can better control blood sugar,improve blood lipids,improve islet function and reduce gastrointestinal discomfort.