二甲双胍单药及不同联合用药方案治疗2型糖尿病的随机对照研究

摘要

目的 观察二甲双胍单药及不同联合用药方案治疗2型糖尿病的临床疗效.方法 回顾分析2017年1月～2018年6月在我院接受治疗的108例2型糖尿病患者临床资料, 依据治疗方案分为A、B、C组, 各36例, A组采用二甲双胍单药治疗, B组采用二甲双胍联合格列吡嗪缓释片治疗, C组采用二甲双胍联合沙格列汀治疗, 比较3组治疗总有效率, 记录患者空腹血糖 (FPG) 、餐后2h血糖 (2 hPG) 、糖化血红蛋白 (HbA1c) 水平及低血糖发生情况.结果 A组治疗总有效率为97.22％、B组为94.44％、C组为94.44％, 差异无统计学意义 (P>0.05);治疗后3组FPG、2 hPG、HbA1c水平均下降, 与治疗前比较差异有统计学意义 (P0.05); A、C组夜间均未发生低血糖, B组发生4例低血糖, 发生率为11.11％, C组肝肾功能异常3例, 发生率为8.33％.结论 二甲双胍单药及不同联合用药方案治疗2型糖尿病均能获得较好的疗效, 但联合用药可以发挥协同作用, 更好的控制血糖水平, 临床可依据患者具体情况选择治疗方案.%Objective To observe the clinical efficacy of metformin monotherapy and different combination regimens in the treatment of type 2 diabetes. Methods The clinical data of 108 patients with type 2 diabetes who were treated in our hospital from January 2017 to June 2018 were retrospectively analyzed. According to the treatment plan, they were divided into groups A, B and C, 36 cases in each group. Group A was treated with metformin monotherapy. Group B was treated with metformin combined with glipizide sustained-release tablets. Group C was treated with metformin combined with saxagliptin. The fasting blood glucose (FPG) , postprandial 2 h blood glucose (2 hPG) , glycosylated hemoglobin (HbA1c) levels were recorded. The incidence of hypoglycemia was compared and the total effective rate of the three groups was compared. Results The total effective rate was 97.22％ in group A, 94.44％ in group B and 94.44％ in group C, the difference was not statistically significant (P>0.05). After treatment, the levels of FPG, 2 hPG and HbA1c decreased, there was significant difference between the two groups (P0.05). There was no hypoglycemia in group A and group C, and 4 cases of hypoglycemia occurred in group B, the incidence rate was 11.11％. Group C liver and kidney function There were 3 abnormalities, the incidence rate was 8.33％. Conclusion Metformin monotherapy and different combination regimens can achieve better curative effect on type 2 diabetes, but the combination can play a synergistic role to better control blood sugar levels. The clinical choice can be based on the patient's specific conditions.