达格列净联合二甲双胍治疗2型糖尿病的效果及对氧化-抗氧化平衡的影响

Efficacy of dapagliflozin combined with metformin in treatment of type 2 diabetes and its effects on oxidation-antioxidant balance

目的探讨达格列净联合二甲双胍治疗2型糖尿病(type 2 diabetes,T2DM)的疗效及对氧化-抗氧化平衡的影响。方法选取2018年11月至2019年11月内分泌科治疗的144例T2DM患者,按随机数字表法分为治疗组和对照组,每组72例。2组入院后均接受常规对症处理,对照组给予二甲双胍治疗,研究组给予达格列净联合二甲双胍治疗,2组治疗时间均为3个月。比较2组临床疗效及药物相关不良反应情况,检测2组治疗前后体重指数(BMI)、血糖指标、氧化产物及抗氧化指标水平的差异。结果治疗后2组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)均显著降低,且研究组较对照组更低(P<0.01);研究组BMI显著低于对照组(P<0.01),而对照组BMI略高于治疗前,但差异无统计学意义(P>0.05);2组超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、总抗氧化能力(T-AOC)均显著升高,且研究组较对照组更高(P<0.01);2组血清中丙二醛(MDA)、终末氧化蛋白产物(AOPP)均显著降低,且研究组较对照组更低(P<0.01);同时,治疗组临床疗效94.4%明显高于对照组的81.94%(P<0.05),研究组不良反应发生率较对照组更低(χ^(2)=5.06,P=0.02)。结论达格列净联合二甲双胍可显著降低T2DM患者血糖和BMI,解除体内高血糖毒性作用,且可在一定程度上减少不良反应,明显改善氧化-抗氧化平衡。

Objective To investigate the therapeutic effects of dapagliflozin combined with metformin on type 2 diabetes(T2DM)and its effects on oxidation-antioxidant balance.Methods A total of 144 patients with T2DM who were treated in our hospital from November 2018 to November 2019 were enrolled in the study,who were randomly divided in to two groups,with 72 cases in each group.The patients in both groups received routine symptomatic treatment after admission,on this basis,the patients in research group were treated by dapagliflozin combined with metformin,however,thepatients in control group were treated by metformin only,with a treatment course of 3 months for both groups.The clinical efficacy,drug-related adverse reactions,and body mass index(BMI),blood glucose indexes,oxidation products and antioxidant indexes were observed and compared between the two groups.Results After treatment,the levels of HbA1c,FPG,and 2hPG in both groups were decreased,moreover,which in research group were significantly lower than those in control group(P<0.01),and BMI in research group was significantly lower than that in control group(P<0.01).And the levels of SOD,CAT and T-AOC in both groups were significantly increased,moreover,which in research group were significantly lower than those in control group(P<0.01).In addition the levels of MDA and AOPP in both groups were decreased,moreover,which in research group were significantly lower than those in control group(P<0.01).Furthermore the effective rate in research group was significantly higher than that in control group(94.4%vs 81.94%,P<0.01),but,the incidence of adverse reactions was significantly lower than that in control group(P<0.01).Conclusion Dapagliflozin combined with metformin can effectively reduce blood glucose and BMI in patients with T2DM,relieve the toxic effects of hyperglycemia,moreover,which can decresase the incidence of adverse reactions to a certain extent,and can significantly improve the oxidation-antioxidant balance.