二甲双胍联合阿卡波糖与格列美脲治疗2型糖尿病的疗效比较研究

Comparative study of curative effect of melbine combined with acarbose and glimepiride for type 2 diabetes mellitus

目的 比较二甲双胍联合阿卡波糖与格列美脲治疗2型糖尿病的临床疗效。方法 选取2020年4月—2021年5月抚州市中医医院收治的60例2型糖尿病患者作为研究对象,采用随机数字表法分为A组和B组,各30例。A组接受二甲双胍联合阿卡波糖治疗,B组接受二甲双胍联合格列美脲治疗。2组患者均持续治疗12周。比较2组临床疗效,治疗前及治疗12周后实验室指标[糖化血红蛋白(HbA_(1c))、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]及不良反应发生率。结果 B组治疗总有效率为96.67%,高于A组的66.67%(χ^(2)=9.017,P=0.003)。治疗12周后,2组HbA_(1c)、FPG、2 hPG、HOMA-IR及TG、LDL-C均较治疗前降低,HOMA-β较治疗前升高,且B组HbA_(1c)、FPG、2 hPG、HOMA-IR及TG、LDL-C较A组更低,HOMA-β较A组更高(P<0.05)。B组不良反应总发生率为6.67%,与A组的10.00%比较,差异无统计学意义(P=1.000)。结论 二甲双胍联合格列美脲药物治疗2型糖尿病的疗效优于二甲双胍联合阿卡波糖,其可更好地控制机体血糖、血脂指标,改善糖脂代谢异常,提高胰岛功能,且安全性较高。

Objective To compare the clinical effect of melbine combined with acarbose and glimepiride for type 2 diabetes mellitus. Methods A total of 60 cases of type 2 diabetes mellitus patients were selected from April 2020 to May 2021 in Fuzhou Traditional Chinese Medicine Hospital, and they were divided into group A and group B according to random number table method, 30 cases in each group. Patients in group A were treated with melbine combined with acarbose, and patients in group B were treated with melbine combined with glimepiride, both groups were treated continually for 12 weeks. Clinical effect, laboratory indexes(HbA_(1c), FPG, 2 hPG, HOMA-β, HOMA-IR, TG, LDL-C) before and after 12 weeks of treatment, incidence of adverse reactions were compared between the two groups. Results Total effective rate of the group B was 96.67%, which was higher than 66.67% of the group A(χ^(2)=9.017, P=0.003). After 12 weeks of treatment, HbA_(1c), FPG, 2 hPG, HOMA-IR, TG, LDL-C in the groups A and B were lower than those before treatment, HOMA-β was higher than that before treatment, and HbA_(1c), FPG, 2 hPG, HOMA-IR, TG, LDL-C of the group B were lower than those of group A, HOMA-β was higher than that of group A(P<0.05). There was no significant difference of the incidence of adverse reactions between the group B(6.67%) and group A(10.00%)(P=1.000). Conclusion Melbine combined with glimepiride have a better clinical effect than melbine combined with acarbose for type 2 diabetes mellitus, it can more effectively control indexes of blood sugar and blood lipid, improve glucose and lipid metabolism, and improve islet function, and with high safety.