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 dapagliflozin combined with metformin in treatment of type 2 diabetes mellius

目的探讨达格列净联合二甲双胍治疗2型糖尿病的临床效果。方法60例服用二甲双胍治疗血糖控制不佳的2型糖尿病患者,随机分为对照组和观察组,每组30例。对照组患者使用二甲双胍联合格列美脲治疗,观察组患者使用二甲双胍联合达格列净治疗。比较两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、体质量指数(BMI)及不良反应发生情况。结果治疗12周后,两组患者FBG、2 h PBG、HbA1c均低于本组治疗前,差异有统计学意义(P<0.05);两组FBG、2 h PBG、HbA1c比较差异无统计学意义(P>0.05);观察组患者BMI较本组治疗前明显下降,差异具有统计学意义(P<0.05);对照组患者BMI与治疗前比较差异无统计学意义(P>0.05);观察组患者BMI(22.4±1.4)kg/m2低于对照组的(24.7±1.8)kg/m2,差异具有统计学意义(P<0.05)。观察组低血糖发生率为3.33%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。观察组总不良反应发生率为20.00%,低于对照组的26.67%,但差异无统计学意义(P>0.05)。结论口服二甲双胍联合达格列净对于2型糖尿病患者的降糖效果肯定,有利于体重的控制,且不良反应少,使用方便,值得推广。

Objective To discuss the clinical effect of dapagliflozin combined with metformin in treatment of type 2 diabetes mellius.Methods A total of 60 type 2 diabetes mellius patients with poor glucose control treated by metformin were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with metformin and glimepiride,and the observation group was treated with metformin and dapagliflozin.Comparison was made on fasting blood glucose,postprandial 2 h blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),body mass index(BMI)before and after treatment and occurrence of adverse reactions between the two groups.Results After 12 weeks of treatment,the levels of FBG,2 h PBG and HbA1c in the two groups was obviously lower than those before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in FBG,2 h PBG and HbA1c between the two groups(P>0.05).The BMI in the observation group was obviously decreased than that before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference in BMI in the control group before and after treatment(P>0.05).The BMI(22.4±1.4)kg/m2 in the observation group was lower than(24.7±1.8)kg/m2 in the control group,and the difference was statistically significant(P<0.05).The incidence of hypoglycemia was 3.33%in the observation group,which was obviously lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).The incidence of total adverse reactions was 20.00%in the observation group,which was lower than 26.67%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Oral metformin combined with dapagliflozin has definite hypoglycemic effect on type 2 diabetes mellitus,which is beneficial to weight control and easy to use with less adverse reactions.It is worth promoting.