二甲双胍片联合盐酸吡格列酮或格列美脲治疗2型糖尿病的降糖效果及安全性探讨

Study on the Hypoglycemic Efficacy and Safety of Metformin Tablets Combined with Pioglitazone Hydrochloride or Glimepiride in the Treatment of Type 2 Diabetes

目的:探究与分析二甲双胍片联合盐酸吡格列酮或格列美脲治疗2型糖尿病的降糖效果及安全性。方法:选取本院自2017年1月-2020年1月收治的单独使用二甲双胍片疗效不佳的2型糖尿病患者90例,采取随机数字表法分为对照组与观察组,每组45例,对照组给予二甲双胍联合格列美脲治疗,观察组给予二甲双胍联合盐酸吡格列酮治疗,对比两组治疗前后血糖指标、胰岛素敏感性、平均血糖波动(MAGE)、C反应蛋白(CRP),同时对比治疗期间的不良反应。结果:观察组治疗后与对照组治疗后相比空腹血糖低、餐后2 h血糖低、糖化血红蛋白低,HOMA-S、Matsuda指数均高,MAGE及CRP较低,差异有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:二甲双胍联合盐酸吡格列酮治疗二甲双胍单药疗效不佳的2型糖尿病患者可发挥较好的降糖效果,可有效调节血糖波动,并对CRP水平进行有效抑制,未增加不良反应,安全性较高。

Objective:To explore and analyze the hypoglycemic efficacy and safety of Metformin Tablets combined with Pioglitazone Hydrochloride or Glimepiride in the treatment of type 2 diabetes.Method:A selection of 90 patients with type 2 diabetes who were treated in our hospital from January 2017 to January 2020 who had poor efficacy of Metformin Tablets alone were divided into the control group and the observation group by a random number table method,with 45 cases in each group.The control group was treated with Metformin combined with Glimepiride,and the observation group was treated with Metformin combined with Pioglitazone Hydrochloride.The blood glucose indexes,insulin sensitivity,average blood glucose excursion(MAGE),and C-reactive protein(CRP)of the two groups were compared before and after treatment,and the adverse reactions was compared.Result:Compared with the control group after treatment,the observation group decreased fasting blood glucose,decreased blood glucose 2 h after meal,decreased glycosylated hemoglobin,increased HOMA-S and Matsuda indexes,lower MAGE and CRP,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Metformin combined with Pioglitazone Hydrochloride in the treatment of type 2 diabetic patients without Metformin monotherapy can exert a good hypoglycemic effect,can effectively regulate blood glucose fluctuations,and effectively inhibit CRP levels,without increasing adverse reactions,and has high safety.