新型降糖药对初治失败的2型糖尿病治疗探讨

Disscussion on the treatment of type 2 diabetes mellitus with new hypoglycemic drugs after initial treatment failure

目的探讨恩格列净联合利格列汀治疗初始治疗失败的2型糖尿病患者的疗效以及安全性。方法选取2018年9月—2020年8月天津港口医院收治的有治疗指征的2型糖尿病患者196例作为研究对象,应用随机数字表法分为对照组和观察组各98例。对照组采用二甲双胍联合瑞格列奈治疗,观察组在二甲双胍的基础上联合恩格列净及利格列汀。比较两组患者的空腹血糖(FBG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbA1c)水平、临床疗效和不良反应发生发生率。结果观察组患者的FBG、2hPBG、HbA1c水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的临床治疗总有效率为97.96%,高于对照组的88.78%,差异有统计学意义(χ^(2)=6.673,P<0.05)。观察组不良反应发生率为15.31%,低于对照组的17.35%,两组比较差异无统计学意义(χ^(2)=0.167,P>0.05)。结论初始治疗失败的2型糖尿病患者加用恩格列净联合利格列汀治疗,临床疗效明显,可有效降低患者血糖水平,不良反应少,安全性高。

Objective To investigate the efficacy and safety of empagliflozin combined with linagliptin in the treatment of patients with type 2 diabetes mellitus who failed initial treatment.Methods A total of 196 patients with type 2 diabetes mellitus who were admitted to Tianjin Port Hospital from September 2018 to August 2020 were selected as the study subjects,and were divided into control group and observation group by random number table method,with 98 cases in each group.The control group was treated with metformin combined with repaglinide,and the observation group was treated with empagliflozin and linagliptin on the basis of metformin.The levels of fasting blood glucose(FBG),2 h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c),clinical efficacy and the incidence of adverse reactions of patients in the two groups were compared.Results The levels of FBG,2hPBG and HbA1c in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The total clinical effective rate of treatment in the observation group was 97.96%,which was higher than 88.78%in the control group,and the difference was statistically significant(χ^(2)=6.673,P<0.05).The incidence of adverse reactions was 15.31%in the observation group,which was lower than 17.35%in the control group,and there was no statistically significang difference the two groups(χ^(2)=0.167,P>0.05).Conclusion Patients with type 2 diabetes who failed initial treatment were treated with empagliflozin combined with linagliptin,which had significant clinical efficacy and could effectively reduce patients'blood glucose level with few adverse reactions and high safety.