恩格列净联合门冬胰岛素治疗单用胰岛素控制不佳的2型糖尿病患者的临床研究

Clinical Study of Empagliflozin Combined with Insulin Aspart in the Treatment of Patients with Type 2 Diabetes Poorly Controlled by Insulin Alone

目的:探讨恩格列净联合门冬胰岛素治疗单用胰岛素控制不佳的2型糖尿病患者的临床疗效。方法:选取2018年1月至2020年10月该院收治的单用胰岛素控制不佳的2型糖尿病患者180例为研究对象,采用随机数字表法分为对照组和观察组,每组90例。对照组患者单用门冬胰岛素治疗,观察组患者在对照组的基础上加用恩格列净治疗。观察两组患者治疗前后血糖、血脂、血压和日均胰岛素用量等指标变化情况,记录不良反应发生情况。结果:观察组患者治疗后的血糖指标(糖化血红蛋白、餐后2 h血糖及空腹血糖)水平明显低于对照组;血脂指标三酰甘油水平明显低于对照组,高密度脂蛋白胆固醇水平明显高于对照组;血压指标收缩压、舒张压水平明显低于对照组;且胰岛素用量明显少于对照组,上述差异均有统计学意义(P<0.05)。观察组患者的不良反应发生率为8.9%(8/90),明显低于对照组的13.3%(12/90),差异有统计学意义(P<0.05)。结论:恩格列净联合门冬胰岛素对单用胰岛素血糖控制不佳的2型糖尿病患者具有更好的血糖控制效果,可有效控制患者血压,减少胰岛素用量。

OBJECTIVE:To probe into the clinical efficacy of empagliflozin combined with insulin aspart in the treatment of type 2 diabetes poorly controlled by insulin alone.METHODS:A total of 180 patients with type 2 diabetes poorly controlled by insulin alone admitted into the hospital from Jan.2018 to Oct.2020 were selected as research subjects,which were selected and divided into the control group and the observation group via random number table,with 90 cases in each group.The control group was treated with insulin aspart alone,while the observation group was given empagliflozin on the basis of control group.The changes of blood glucose,blood lipid,blood pressure,average daily insulin dosage and other indicators were compared between two groups before and after treatment.RESULTS:The indicators of blood glucose(glycosylated hemoglobin,2 h postprandial blood glucose and fasting blood glucose)in the observation groups after treatment were significantly lower than those of the control group;in terms of blood lipid indicators,the triglycerides was significantly lower than that in the control group,while the high density lipoprotein cholesterol was significantly higher than that in the control group;in terms of blood pressure indicators,the systolic blood pressure and diastolic blood pressure were significantly lower than those in the control group;and the insulin dosage was significantly less than that in the control group,with statistically significant differences(P<0.05).The incidence of adverse drug reactions in the observation group was 8.9%(8/90),significantly lower than 13.3%(12/90)in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:Empagliflozin combined with insulin aspart has better blood glucose control effect on type 2 diabetic patients with poorly controlled by insulin alone,which can effectively control patients’blood pressure and reduce insulin dosage.