西格列汀治疗口服单一降糖药物控制不良的2型糖尿病患者的疗效观察

摘要

目的 评价口服单一药物控制不良的2型糖尿病患者加用西格列汀的临床疗效及安全性.方法 150例口服单一药物控制不良的2型糖尿病患者随机分为对照组73例和观察组77例.对照组采用单一口服药物,同时口服安慰剂;观察组在对照组基础上,将安慰剂替换为西格列汀(100 mg/片),治疗持续10周.对比治疗前后体质量指数(BMI)、空腹血糖(FPG)、C反应蛋白(CRP)、胰岛素敏感指数(HOMA-IR)、胰岛β细胞功能(HOMA-β)、多伦多临床评分系统(TCSS)、糖化血红蛋白(HbA1c)及危险因素控制情况、不良反应发生情况.结果 观察组完成研究73例,对照组70例.治疗后,2组FPG、HbA1c、CRP、TCSS评分、HOMA-IR显著低于治疗前,观察组HbA1c、CRP、TCSS评分、HOMA-IR显著低于对照组(P＜0.05);2组HOMA-β高于治疗前,观察组高于对照组,观察组血糖控制率高于对照组,差异有统计学意义(P＜0.05).2组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 西格列汀治疗单一口服药治疗效果不佳的2型糖尿病可增进疗效,有助于危险因素控制,提高血糖控制效果,并不会增加不良反应发生风险.%Objective To evaluate the clinical efficacy and safety of sitagliptin in treatment of type 2 diabetic patients with bad control by oral administration of single hypoglycemic drugs.Methods Totally 150 type 2 diabetic patients with bad control by oral administration of single hypoglycemic drugs were divided into control group (n =73) and observation group (n =77).The control group was treated with single hypoglycemic drug and placebo,the experimental group was treated with sitagliptin (100 mg per pill) instead of placebo for 10 weeks.Changes of body mass index (BMI),fasting plasma glucose (FPG),C-reactive protein (CRP),homeostasis model assessment of insulin resistance index (HOMA-IR),homeostasis model assessment of β-cell function index (HOMA-β),Toronto Clinical Scoring System(TCSS),glycosylated hemoglobin (HbAl c),risk factors control and adverse drug reactions were compared before and after treatment.Results Finally 73 cases completed study in the observation group and 70 cases completed in the control group.Compared with before treatment,the FPG,HbAlc,CRP,TCSS deceased significantly in both groups,and the HbAlc、CRP、TCSS in the experimental group were significantly lower than control group (P ＜ 0.05).After treatment,the HOMA-β in both groups was significantly higher than that before treatment,and the observation group was significantly higher than control group.The blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups (P ＞ 0.05).Conclusion Sitagliptin is effective in treating type 2 diabetic patients with bad control by oral administration of single hypoglycemic drugs,which can control risk factors,improve the effect of blood glucose control,and not increase the risk of adverse reactions.