恩格列净联合黄连素治疗脆性2型糖尿病的临床效果分析

Analysis of clinical effect of empagliflozin combined with berberine in the treatment of fragile type 2 diabetes mellitus

目的分析恩格列净联合黄连素治疗脆性2型糖尿病的临床效果。方法98例脆性2型糖尿病患者为研究对象,依据随机数字表法分为观察组和对照组,每组49例。两组均采用门冬胰岛素治疗。对照组在此基础上采用恩格列净治疗,观察组在对照组基础上加用黄连素治疗。比较两组血糖水平、血糖波动情况、血脂水平、肾功能水平、氧化产物与抗氧化指标及用药相关不良反应发生情况。结果治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白分别为(6.89±0.64)mmol/L、(8.62±1.04)mmol/L、(6.42±0.58)%,低于对照组的(7.58±0.52)mmol/L、(9.35±1.24)mmol/L、(7.58±0.47)%,差异有统计学意义(P<0.05)。治疗后,观察组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)分别为(0.80±0.23)、(4.32±0.26)、(2.42±0.25)mmol/L,低于对照组的(0.90±0.24)、(5.05±0.35)、(2.89±0.42)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组餐后血糖波动幅度(PPGE)为(0.60±0.24)mmol/L、日间血糖平均绝对差(MODD)为(1.42±0.35)mmol/L,均低于对照组的(2.15±0.65)、(2.12±0.46)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组血尿素氮、血肌酐、血清胱抑素C分别为(4.30±1.06)mmol/L、(81.24±12.06)μmol/L、(4.65±1.05)mg/L,低于对照组的(6.24±1.08)mmol/L、(94.25±10.65)μmol/L、(6.35±0.24)mg/L,内生肌酐清除率(115.15±15.36)ml/(min·1.73 m^(2))高于对照组的(105.25±14.24)ml/(min·1.73 m^(2)),差异有统计学意义(P<0.05)。治疗后,观察组超氧化物歧化酶(SOD)为(96.24±5.39)U/L、过氧化氢酶(CAT)为(41.36±3.58)U/ml,高于对照组的(88.52±6.37)U/L、(37.25±3.46)U/ml,差异有统计学意义(P<0.05)。两组用药相关不良反应发生率比较,差异无统计学意义(P>0.05)。结论相比跟格列净单一用药,联合黄连素可强化对脆性2性糖尿病的疗效,且安全性良好。

Objective To analyze the clinical effect of empagliflozin combined with berberine in the treatment of fragile type 2 diabetes mellitus.Methods 98 patients with fragile type 2 diabetes mellitus were selected as research subjects,and were divided into an observation group and a control group according to random number table,with 49 cases in each group.Both groups were treated with insulin aspart.On this basis,the control group was treated with empagliflozin,and the observation group was treated with berberine on the basis of the control group.Blood glucose level,blood glucose fluctuation,blood lipid level,renal function level,oxidation products and antioxidant indexes and drug related adverse reactions were compared between the two groups.Results After treatment,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were(6.89±0.64)mmol/L,(8.62±1.04)mmol/L and(6.42±0.58)%,which were lower than(7.58±0.52)mmol/L,(9.35±1.24)mmol/L and(7.58±0.47)%in the control group,and the difference was statistically significant(P<0.05).After treatment,the triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)in the observation group were(0.80±0.23),(4.32±0.26)and(2.42±0.25)mmol/L,which were lower than(0.90±0.24),(5.05±0.35)and(2.89±0.42)mmol/L in the control group,and the difference was statistically significant(P<0.05).After treatment,the eostprandial glucose excursion(PPGE)and the means of daily differences(MODD)in the observation group were(0.60±0.24)and(1.42±0.35)mmol/L,which were lower than(2.15±0.65)and(2.12±0.46)mmol/L in the control group,and the difference was statistically significant(P<0.05).After treatment,the blood urea nitrogen,serum creatinine and serum cystatin C in the observation group were(4.30±1.06)mmol/L,(81.24±12.06)μmol/L and(4.65±1.05)mg/L,which were lower than(6.24±1.08)mmol/L,(94.25±10.65)μmol/L,(6.35±0.24)mg/L in the control group;the endogenous creatinine clearance rate of(115.15±15.36)ml/(min·1.73 m^(2))in the observation group was higher than(105.25±14.24)ml/(min·1.73 m^(2))in the control group;the difference was statistically significant(P<0.05).After treatment,the superoxide dismutase(SOD)and catalase(CAT)in the observation group were(96.24±5.39)U/L and(41.36±3.58)U/ml,which were higher than(88.52±6.37)U/L and(37.25±3.46)U/ml in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of drug-related adverse reactions between the two groups(P>0.05).Conclusion Compared with gliflozin alone,combined with berberine can enhance the efficacy of fragile 2 diabetes,and have good safety.