达格列净联合盐酸二甲双胍治疗2型糖尿病患者的临床疗效

Efficacy Analysis of Dapagliflozin Combined with Metformin in the Treatment of Patients with Type 2 Diabetes

【目的】探讨达格列净联合盐酸二甲双胍治疗2型糖尿病(T2DM)患者的临床疗效。【方法】选取2020年9月至2023年9月在本院诊治的87例T2DM患者,采用随机数字表法分为观察组(采用达格列净联合盐酸二甲双胍治疗,n=44)和对照组(采用盐酸二甲双胍治疗,n=43)。比较两组患者治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血糖标准差(sDBG)、平均血糖波动幅度(MAGE)]、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、胱抑素C(cys C)、血清同型半胱氨酸(Hcy)]、内分泌激素指标[空腹胰岛素(Fins)、胰岛β细胞指数(HOMA-β)、胰岛素敏感指数(HOMA-IR)]、氧化应激指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)]水平及不良反应发生率。【结果】与治疗前比较,两组患者治疗后FPG、2hPG、HbA1c、sDBG、MAGE及CRP、TNF-α、IL-6、Hcy、cys C水平均下降,且观察组显著低于对照组,差异均有统计学有意义(P<0.05)。与治疗前比较,两组患者治疗后Fins、SOD、CAT水平及HOMA-β均升高,且观察组显著高于对照组;两组治疗后HOMA-IR均下降,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为13.64%,与对照组的23.26%比较,差异无统计学意义(χ^(2)=1.341,P=0.247)。【结论】达格列净联合盐酸二甲双胍治疗T2DM患者,可有效降低血糖和炎症因子水平,改善胰岛细胞功能,且安全性良好,值得临床推广应用。

【Objective】To investigate the clinical efficacy of dapagliflozin combined with metformin hydrochloride in the treatment of type 2 diabetes(T2DM).【Methods】A total of 87 patients with type 2 diabetes treated in our hospital from September 2020 to September 2023 were selected and divided into the observation group(treated with dapagliflozin combined with metformin hydrochloride,n=44)and the control group(treated with metformin hydrochloride,n=43)by random number table method.Fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG)and glycosylated hemoglobin(HbA1c),blood glucose standard deviation(sDBG),mean blood glucose fluctuation range(MAGE),inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum homocysteine(Hcy),cystatin C(cys C)],endocrine hormones[fasting insulin(Fins),pancreatic islandβcell index(HOMA-β),insulin sensitivity index(HOMA-IR)],oxidative stress level[superoxide dismutase(SOD),catalase(CAT)]and incidence of adverse reactions were compared between the two groups before and after treatment.【Results】Compared to before treatment,the levels of FPG,2hPG,HbA1c,sDBG,MAGE,CRP,TNF-α,IL-6,Hcy and cys C in the two groups of T2DM patients decreased after treatment,while the above measurements in the observation group were significantly lower than those in the control group with statistical significance(P<0.05).Fins,SOD,CAT levels and HOMA-βof both groups increased after treatment if compared with before treatment,and their values in the observation group were significantly higher than those in the control group.The HOMA-IR of both groups decreased after treatment,and HOMA-IR level in the observation group was significantly lower than that in the control group.The difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 13.64%,compared with 23.26%in the control group,the difference was not statistically significant(χ^(2)=1.341,P=0.247).【Conclusion】Dapagliflozin combined with metformin hydrochloride can effectively reduce the levels of blood glucose and inflammatory factors,improve the function of islet cells in the treatment of type 2 diabetes patients,and it is safe and worthy of clinical application.