沙格列汀和格列美脲联合二甲双胍治疗2型糖尿病疗效观察.docVIP

沙格列汀和格列美脲联合二甲双胍治疗2型糖尿病疗效观察 　　【摘 要】 目的：探讨二肽基肽酶4抑制剂沙格列汀与磺脲类促胰岛素分泌剂格列美脲联合二甲双胍治疗2型糖尿病的临床效果及价值。方法：选取在我院接受治疗的70例2型糖尿病患者，随机分为35例观察组和35例对照组，观察组采用沙格列汀联合二甲双胍治疗，对照组采用格列美脲联合二甲双胍治疗，比较分析两组治疗前及治疗3个月后的血糖控制情况（糖化血红蛋白HbA1c）、体重的变化情况，记录两组低血糖发生事件。结果：治疗后，两组的HbA1c与治疗前相比，均显著下降，差异有统计学意义（P0.05）；观察组治疗后体重增加趋势，对照组治疗后体重有减轻趋势，但两者不具有统计学意义（P0.05），治疗前组间体重无明显差异（P0.05），治疗后组间体重差异具有统计学意义（P0.05）；观察组与对照组发生低血糖事件的例数分别为0例和5例，差异有统计学意义（P0.05）。结论：在2型糖尿病患者的治疗中，当单用一线药物二甲双胍控制血糖不达标时，采用联合二肽基肽酶4抑制剂沙格列汀，较之联合磺脲类促胰岛素分泌剂格列美脲，两者均能够有效控制血糖，但前者能够减少体重增加及低血糖风险，具有较好的临床疗效，值得临床推广。 　　【关键词】 2型糖尿病 二肽基肽酶4抑制剂 沙格列汀 体重 低血糖 　　【abstract】 Objective： to assess the clinic efficacy of dipeptidyl peptidase 4 inhibitor Saxagliptin and sulfonylureas insulin secretagogues glimepiride when combine with metformin in the treatment of type 2 diabetes mellitus. Method： choose 70 cases with type 2 diabetes in our hospital for treatment，35 cases were randomly divided into observation group，and 35 cases into control group，the observation group were treated with saxagliptin and metformin， the control group were treated with glimepiride and metformin， compare and analyse the following outcomes of two groups with different treatment before and after 3 months：glycemic control （glycated hemoglobin HbA1c）， the change of weight， the incidence of hypoglycemia. Results： after treatment， the HbA1c of two groups were all decreased significantly（P0.05）；after treatment，the average weight of the observation group decreased， and the control group increased， but both were not significant（P0.05），after treatment，the difference of average weight between the two groups was significant（P0.05）. Conclusion： in the treatment of patients with type 2 diabetes，when use first-line drug metformin alone can not achive the glycemic control goal， saxagliptin with metformin，and glimepiride with metformin ，both were efficient，except for saxagliptin has a superior advantage of decreasing weight gain and hypoglycemia，which is worth of clinical application. 　　【key words】 type 2 diabetes