瑞格列奈联合二甲双胍与胰岛素泵强化治疗对初诊断2型糖尿病疗效的对比研究

摘要

Objective To evaluate the efficacy and safety of repaglinide combined with deformin and insulin pump continuous subcutaneous infusion in newly diagnosed type 2 diabetic patients.Methods All 60 newly diagnosed type 2 diabetic patients were divided randomly into two groups,one treated by repaglinide c ombined with deformin before three meals (group A),the other treated by insulin pump continuous sub-cutaneous infusion (group B).FPG,2 hPG,FC-P,2 hC-P,time of glycemic control,hypoglycemia were observed at the baseline and the end of the trail.Results After 2 weeks treatment,the level of FPG, 2 hPG decreased significantly form baseline in two groups (P <0.05);There were no significant difference between two groups in time of glycemic control,dosage of insulin and incidence of hypoglycemia;The level of FC-P,2 hC-P were higher after treatment in two groups (P <0.05).After half year treatment,the lev-el of blood sugar were also efficacy controled.Repaglinide were withdrawaled in group A,deformin were only took in two groups.Conclusion In newly diagnosed type 2 diabetic patients,treatment with repaglinide combined with deformin would improveβ-cell function with the same efficacy and safety as insulin pump.%目的：评价瑞格列奈（诺和龙）联合二甲双胍（格华止）与胰岛素泵持续皮下输注治疗初诊断2型糖尿病患者的有效性和安全性。方法选择60例初诊断的2型糖尿病患者，随机分为两组，分别使用诺和龙联合格华止（A 组）和胰岛素泵持续皮下输注（B 组）强化治疗方案，观察治疗前后的空腹血糖（FPG）、餐后2 h 血糖（2 hPG）、空腹 C 肽（FC-P）、餐后2 hC 肽（2 hC-P）、血糖达标时间、低血糖发生率的差异。结果治疗2 w 后，两组患者的 FPG、2 hPG 均较治疗前显著降低（P ＜0．01）；两组血糖达标时间、低血糖发生率差异无统计学意义；治疗2 w 后，两组 FC-P、2 hC-P 均较治疗前显著增加（P ＜0．01）；6个月后，两组患者血糖均达标，且 A 组已停用诺和龙，两组患者均仅服格华止。结论对于初诊断的2型糖尿病患者，与胰岛素泵持续皮下输注方案比较，诺和龙联合格华止可以同样安全、有效地控制血糖，使胰岛β细胞功能得到恢复。