尼可地尔联合二甲双胍治疗2型糖尿病合并冠心病患者的疗效和安全性观察

Efficacy and safety of nicorandil combined with metformin in the treatment of type 2 diabetes mellitus complicated with coronary heart disease

目的探究尼可地尔联合二甲双胍治疗2型糖尿病合并冠心病患者的疗效和安全性。方法本研究为随机对照试验。选取济南市民族医院内科2021年6月至2022年1月收治的92例2型糖尿病合并冠心病患者作为研究对象,采用随机数字表法分为联合组和常规组,均46例。常规组女26例,男30例,年龄50~80(69.41±8.02)岁;联合组女25例,男31例,年龄56~79(68.74±7.79)岁。常规组口服二甲双胍片治疗,联合组口服二甲双胍片+尼可地尔治疗。治疗2个月后评估两组血糖指标、心功能指标[左心室舒张末期容积指数(LVED-VI)、左心室射血分数(LVEF)]、疗效,记录药物不良反应发生率。采用t检验、χ^(2)检验、秩和检验。结果治疗后,联合组餐后2 h血糖、空腹血糖低于常规组[(8.14±0.61)mmol/L比(9.89±1.04)mmol/L,(6.10±0.78)mmol/L比(6.89±0.90)mmol/L](t=4.499,P<0.001;t=9.844,P<0.001)。两组治疗后LVEF均高于治疗前,且联合组LVEF高于常规组[(48.37±6.02)%比(44.12±5.81)%](t=2.205,P=0.030);两组治疗后LVED-VI均低于治疗前,且联合组LVED-VI低于常规组[(63.42±9.13)比(67.29±8.93)](t=3.696,P<0.001)。经秩和检验,联合组疗效优于常规组,差异有统计学意义(Z=2.049,P=0.040)。两组不良反应发生率比较差异无统计学意义(χ^(2)=0.449,P=0.503)。结论尼可地尔联合二甲双胍治疗2型糖尿病合并冠心病患者效果优越,改善患者的心功能,且安全性良好。

Objective To explore the efficacy and safety of nicorandil combined with metformin in the treatment of type 2 diabetes mellitus complicated with coronary heart disease.Methods It was a randomized controlled trial.A total of 92 patients with type 2 diabetes mellitus complicated with coronary heart disease admitted to Internal Medicine,Jinan Minzu Hospital from June 2021 to January 2022 were selected as the research objects.They were divided into a combined group and a conventional group by the random number table method,with 46 cases in each group.In the conventional group,there were 26 females and 30 males,aged 50-80 years,with an age of(69.41±8.02)years old.In the combined group,there were 25 females and 31 males,aged 56-79 years,with an age of(68.74±7.79)years old.The conventional group was treated with metformin tablets,and the combined group was treated with metformin tablets plus nicorandil.After 2 months of treatment,the blood glucose indexes,cardiac function indexes[left ventricular end-diastolic volume index(LVD-VI)and left ventricular ejection fraction(LVEF)],and efficacies of the two groups were evaluated,and the incidence of adverse drug reactions was recorded.t test,χ^(2)test,and rank sum test were used.Results After treatment,the 2 h postprandial blood glucose and fasting blood glucose in the combined group were lower than those in the conventional group[(8.14±0.61)mmol/L vs.(9.89±1.04)mmol/L,(6.10±0.78)mmol/L vs.(6.89±0.90)mmol/L](t=4.499,P<0.001;t=9.844,P<0.001).The LVEF after treatment was higher than that before treatment in both groups,and the LVEF in the combined group was higher than that in the conventional group[(48.37±6.02)%vs.(44.12±5.81)%](t=2.205,P=0.030).The LVED-VI after treatment was lower than that before treatment in both groups,and the LVED-VI in the combined group was lower than that in the conventional group[(63.42±9.13)vs.(67.29±8.93)](t=3.696,P<0.001).The rank sum test showed that the efficacy of the combined group was better than that of the conventional group,with a statistically significant difference(Z=2.049,P=0.040).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.449,P=0.503).Conclusion Nicorandil combined with metformin in the treatment of type 2 diabetes mellitus complicated with coronary heart disease has superior hypoglycemic effect,and improves the cardiac function,with good safety.