恩格列净或卡格列净联合二甲双胍对单药失效的T2DM患者的治疗效果的对比研究

Comparative study of caglilipzin combined with metformin and enaglizin combined with metformin in T2DM patients with monotherapy failure

目的:探讨恩格列净与卡格列净分别联合二甲双胍对单药失效的2型糖尿病(DiabetesMellitus Type 2,T2DM)患者的效果。方法:随机将2021年2月至2023年2月我院收治的70例单药失效的T2DM患者分成两组。对照组采用恩格列净+二甲双胍治疗;观察组采用卡格列净+二甲双胍治疗,两组均连续治疗3 m。分析比较两组的血糖水平、肾功能、血脂水平及不良反应。结果:治疗后,两组的空腹血糖、糖化血红蛋白、餐后2 h血糖水平均显著低于治疗前(P<0.05),但两组间比较无显著差异(P>0.05)。观察组治疗后的血肌酐、血尿素氮、24 h尿总蛋白水平均显著低于对照组(P<0.05)。治疗后,观察组的总胆固醇、甘油三酯水平均显著低于对照组,高密度脂蛋白胆固醇水平显著高于对照组(P<0.05)。两组的不良反应无显著差异(P>0.05)。结论:恩格列净或卡格列净联合二甲双胍在治疗单药失效的T2DM患者中均能有效控制血糖指标,且均无明显不良反应,但卡格列净联合二甲双胍对改善患者肾功能、降低血脂水平的作用更佳。

Objective:To investigate the efficacy of enoglizin and caglizin combined with metformin in patients with Diabetes Mellitus Type 2(T2DM)after failure of single drug.Methods:70 T2DM patients with monotherapy failure admitted to our hospital from February 2021 to February 2023 were divided into two groups according to random number table method.The control group was treated with englaglizin+metformin.Observation group was treated with caglilipzin+metformin.The blood glucose level,renal function,blood lipid level and adverse reactions of the two groups were analyzed and compared.Results:After treatment,Fasting Blood Glucose(FPG),Hemoglobin A1c(HbA1c)and 2 hours Postprandial Plasma Glucose(2h PBG)were measured in both groups.2h PBG levels were significantly lower than before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).Serum creatinine(SCr),blood urea nitrogen(Blood urea nitrogen,BUN)and 24 hours urinary total protein(24h PRO)levels in observation group were significantly lower than those in control group after treatment(P<0.05).After treatment,the levels of Total Cholesterol(TC)and Triglyceride(TG)in the observation group were significantly lower than those in the control group,and the levels of High-density lipoprotein cholesterol(HDL-C)were significantly lower than those in the control group.The level of HDL-C was significantly higher than that of control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Both enaglipzin and caglipzin combined with metformin can effectively control blood glucose indexes in T2DM patients with monotherapy failure,and there are no obvious adverse reactions.However,caglipzin combined with metformin has a better effect on improving renal function and reducing lipid levels in patients.