吡格列酮或达格列净联合二甲双胍治疗2型糖尿病患者临床疗效比较分析

Clinical efficacy of pioglitazone or dapagliflozin combined with metformin in the treatment of patients with type 2 diabetes mellitus:a comparative analysis

目的比较吡格列酮或达格列净联合二甲双胍治疗2型糖尿病(T2DM)患者的临床效果。方法选取2018年12月至2019年10月在我院治疗的T2DM患者82例作为研究对象,采用随机数字法分为吡格列酮组和达格列净组,每组41例。吡格列酮组患者给予吡格列酮联合二甲双胍治疗,达格列净组患者给予达格列净联合二甲双胍治疗,疗程均为6个月。比较两组患者治疗前后的体质量指数(BMI)、体质量、糖代谢、脂代谢水平及不良反应发生的情况。结果治疗前,两组患者的BMI、体质量比较差异无统计学意义(P>0.05);治疗6个月后,两组患者的BMI、体质量均显著降低,但两组比较差异无统计学意义(P>0.05)。治疗前,两组患者的空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)水平比较差异无统计学意义(P>0.05);治疗6个月后,两组患者的FPG、2hPG、HbAlc水平均显著降低,达格列净组患者的水平显著低于吡格列酮组,差异有统计学意义(P<0.05)。治疗前,两患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较差异无统计学意义(P>0.05);治疗6个月后,两组患者的TC、TG和LDL-C水平均显著降低,HDL-C水平显著升高;达格列净组患者的TC、TG和LDL-C水平显著低于吡格列酮组,HDL-C水平显著高于吡格列酮组,差异有统计学意义(P<0.05)。治疗期间,吡格列酮组患者的不良反应发生率(19.5%)显著高于达格列净组(4.9%),差异有统计学意义(P<0.05)。结论达格列净联合二甲双胍治疗改善2型糖尿病患者血糖和血脂水平的效果优于吡格列酮联合二甲双胍治疗,不良反应发生率更低。

Objective To compare the clinical effects of pioglitazone or dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)patients.Methods A total of 82 T2DM patients who were treated in our hospital from December 2018 to October 2019 were selected as the research objects,and they were divided into pioglitazone group and dapaglitazone group by the random number method,with 41 cases in each group.Patients in the pioglitazone group were treated with pioglitazine combined with metformin,whereas patients in the dapaglitazine group were treated with dapaglitazone combined with metformin,for a six-month treatment course.The body mass index(BMI),body weight,glucose metabolism,lipid metabolism levels and adverse reactions of the two groups before and after treatment were compared.Results There were no statistically significant differences in BMI and bodyweight between the two groups before treatment(P>0.05).The BMI and bodyweight of the two groups significantly decreased after 6 months of treatment,but the differences between the two groups were not statistically significant(P>0.05).There were no statistically significant differences in fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),and glycosylated hemoglobin(HbAlc)levels between the two groups before treatment(P>0.05).The FPG,2hPG,and HbAlc levels of the two groups significantly decreased,and the levels mentioned above in the dapagliflozin group were significantly lower than those in the pioglitazone group after 6 months of treatment,with statistically significant differences(P<0.05).There were no statistically significant differences in the levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)between the two groups before treatment(P>0.05).After 6 months of treatment,the TC,TG and LDL-C levels of the two groups significantly decreased,whereas the HDL-C levels significantly increased,and the TC,TG and LDL-C levels of the dapagliflozin group were significantly lower than those of the pioglitazone group,and the HDL-C level was significantly higher than that of the pioglitazone group,with statistically significant differences(P<0.05).The incidence of adverse reactions in the pioglitazone group(19.5%)was significantly higher than that in the dapaglitazine group(4.9%)during the treatment,and the difference was statistically significant(P<0.05).Conclusion Employing dapaglitazine combined with metformin for treatment has a superior effect to using pioglitazone combined with metformin for treatment,in which the former can improve blood glucose and blood lipid levels in patients with T2DM,and the incidence of adverse reactions is lower.