CAJ | 학술논문

目的对用单药和(或)联合口服降糖药物后血糖控制不佳的2型糖尿病患者,比较二甲双胍缓释片分别联合格列喹酮或阿卡波糖治疗的疗效和安全性.方法选取符合研究方案的2型糖尿病患者140例,男74例,女66例,平均年龄(56±10)岁,随机分为二甲双胍(1500 mg/d)+格列喹酮(初始剂量为30 mg,2次/d)组70例和二甲双胍(1500 mg/d)+阿卡波糖(初始剂量为50mg,2次/d)组70例,维持治疗14周.在基线和治疗结束时分别进行各项生化指标和胰岛素反应等检查.以糖化血红蛋白(HbA1c)是否达标为因变量,调整年龄、性别、糖尿病病程、基线时β胰岛功能和体重指数、治疗分组后,进行Logistic多元逐步回归分析.结果 (1)经14周治疗后,两组HbA1c均较治疗前显著下降,格列喹酮组为(7.4±1.1)%,阿卡波糖组为(7.8±1.1)%,格列喹酮组下降幅度更大,平均HbA1c下降1.7%(t=-4.404,P=0.0001),差异有统计学意义.HbA1c<6.5%的达标率在格列喹酮组有高于阿卡波糖组趋势(25.71%比12.86%,χ2=3.72,P=0.054).(2)两组胰岛素抵抗指数均较各自治疗前显著下降,但两组间比较无显著差异.二甲双胍+格列喹酮组在治疗过程中无严重低血糖事件或其他严重不良事件发生,患者耐受件良好.结论格列喹酮在单药和(或)联合治疗失败的2型糖尿病中与二甲双胍联合治疗能有效降低2型糖尿病患者血糖,在HbA1c达标率较高的同时安全性较好.
목적 대용단약화(혹)연합구복강당약물후혈당공제불가적2형당뇨병환자,비교이갑쌍고완석편분별연합격렬규동혹아잡파당치료적료효화안전성.방법 선취부합연구방안적2형당뇨병환자140례,남74례,녀66례,평균년령(56±10)세,수궤분위이갑쌍고(1500 mg/d)+격렬규동(초시제량위30 mg,2차/d)조70례화이갑쌍고(1500 mg/d)+아잡파당(초시제량위50mg,2차/d)조70례,유지치료14주.재기선화치료결속시분별진행각항생화지표화이도소반응등검사.이당화혈홍단백(HbA1c)시부체표위인변량,조정년령、성별、당뇨병병정、기선시β이도공능화체중지수、치료분조후,진행Logistic다원축보회귀분석.결과 (1)경14주치료후,량조HbA1c균교치료전현저하강,격렬규동조위(7.4±1.1)%,아잡파당조위(7.8±1.1)%,격렬규동조하강폭도경대,평균HbA1c하강1.7%(t=-4.404,P=0.0001),차이유통계학의의.HbA1c<6.5%적체표솔재격렬규동조유고우아잡파당조추세(25.71%비12.86%,χ2=3.72,P=0.054).(2)량조이도소저항지수균교각자치료전현저하강,단량조간비교무현저차이.이갑쌍고+격렬규동조재치료과정중무엄중저혈당사건혹기타엄중불량사건발생,환자내수건량호.결론 격렬규동재단약화(혹)연합치료실패적2형당뇨병중여이갑쌍고연합치료능유효강저2형당뇨병환자혈당,재HbA1c체표솔교고적동시안전성교호.
Objective To understand the efficacy and safety of sufficient dose of metformin either plus gliquidone or plus acarbose for the treatment of type 2 diabetes mellitus. Method One hundred and forty patients with type 2 diabetes who were inadequately controlled with previous therapy were randomized to receive sustained-release metformin (1500 mg/d) in combination with either gliquidone (start with 30 mg, bid) or acarbose(start with 50 mg,bid) for 14 weeks. The anthropometric parameters, fasting blood glucose levels, lipid profiles, HbA1c and post-challenge glucose and insulin responses were measured at baseline and at the end of treatment. Results After 14 weeks treatment, the level of the glycated hemoglobin A1c (HbA1c) in the 2 group were both decreased than before(metformin + gliquidoue group with (7.4±1.1)%, metformin + acarbose group with (7.8±1.1)%). The level of HbA1c decreased significantly more in metformin plus gliquidone group (1.7%) than in mefformin plus acarbose group (0.9%), P =0.0001. The rate of HbA1c <6.5% was 25.71% in mefformin plus gliquidone group, compared to 12.86% in mefformin plus acarbose group(P =0.054). The insulin resistance index(HOMA-IR) and the beta-cell function index (HOMA-β) improved significantly in both groups, but no difference was observed between the two groups. Conclusion As compared to mefformin plus acarbose, the combined therapy with mefformin plus gliquidone more significantly improved glycemic control and was well tolerated among inadequately controlled patients with type 2 diabetes.