不同剂量二甲双胍联合磷酸西格列汀治疗2型糖尿病患者的临床疗效及安全性观察

Clinical Efficacy and Safety of Different Doses of Metformin Combined with Sitagliptin Phosphate in the Treatment of Patients with Type 2 Diabetes Mellitus

目的探究不同剂量二甲双胍联合磷酸西格列汀治疗2型糖尿病(T2DM)的临床疗效及安全性。方法选取2019年2月-2022年2月佳木斯市中心医院收治的90例T2DM病例,按照随机数字表法分为高剂量组(45例)和低剂量组(45例)。两组均采用二甲双胍联合磷酸西格列汀治疗,高剂量组二甲双胍给药剂量为0.85 g/次,2次/d;低剂量组二甲双胍给药剂量为0.50 g/次,2次/d。比较两组血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbA1c)]、胰岛功能[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、不良反应。结果两组治疗后HbA1c、FPG、2hPBG低于治疗前,且高剂量组HbA1c、FPG、2hPBG低于低剂量组(P<0.05);高剂量组治疗后FINS高于低剂量组,HOMA-IR低于低剂量组(P<0.05);高剂量组治疗后TG、TC、LDL-C低于低剂量组,HDL-C高于低剂量组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论高剂量二甲双胍联合磷酸西格列汀治疗T2DM效果可观,相较于低剂量方案,其在血糖指标、胰岛功能及血脂水平的调节中具有更高优势,且安全性好。

Objective To explore the clinical efficacy and safety of different doses of metformin combined with sitagliptin phosphate in the treatment of type 2 diabetes mellitus(T2DM).Methods A total of 90 cases of T2DM admitted to Jiamusi Central Hospital from February 2019 to February 2022 were selected and divided into high-dose group(45 cases)and low-dose group(45 cases)according to the random number table method.Both groups were treated with metformin combined with sitagliptin phosphate.The dose of metformin in the high-dose group was 0.85 g/time,twice daily.The dose of metformin in the low-dose group was 0.50 g/time,twice daily.The blood glucose indexes[fasting blood glucose(FBG),2 h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c)],islet function[fasting insulin(FINS),insulin resistance index(HOMA-IR)],blood lipid indexes[total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]and adverse reactions were compared between the two groups.Results After treatment,HbA1 c,FPG and 2hPBG in the two groups were lower than those before treatment,and HbA1c,FPG and 2hPBG in the high-dose group were lower than those in the low-dose group(P<0.05).After treatment,FINS in the high-dose group was higher than that in the low-dose group,and HOMA-IR was lower than that in the low-dose group(P<0.05).After treatment,TG,TC and LDL-C in the high-dose group were lower than those in the low-dose group,and HDL-C was higher than that in the low-dose group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High-dose metformin combined with sitagliptin phosphate is effective in the treatment of T2DM.Compared with low-dose regimen,it has higher advantages in the regulation of blood glucose index,islet function and blood lipid level,and has good safety.