CAJ | 학술논문

目的：探讨西格列汀联合二甲双胍治疗肥胖2型糖尿病患者并控制血糖的临床疗效。方法筛选86例肥胖2型兼血糖控制不佳的新诊断的糖尿病患者。随机分为两组，两组患者均进行糖尿病饮食控制和适量运动。在此基础上，对照组患者采用阿卡波糖联合二甲双胍治疗；治疗组患者采用西格列汀联合二甲双胍治疗，治疗时间均为12周，分别于治疗前后检测两组患者糖基化血红蛋白（HbA1c）、空腹血糖（ FPG）、餐后2 h血糖（2 h FPG）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、体重指数（BMI）以及胰岛β细胞功能指数（HOMA-β）等指标。结果治疗组治疗后FPG、2 h FPG 、HbA1c、BMI与对照组治疗后比较，差异均有统计学意义（t分别=13.73、6.57、13.17、59.53，P均＜0.05），而HOMA-β比较差异无统计学意义（t=1.10，P＞0.05）；且治疗组治疗后TC、TG、LDL-C、HDL-C与对照组治疗后比较，差异均有统计学意义（t分别=12.26、7.75、4.73、4.03，P均＜0.05）。结论西格列汀联合二甲双胍能有效降低血糖血脂，并控制患者体重，是针对2型糖尿病肥胖患者的有效治疗方案。
목적：탐토서격렬정연합이갑쌍고치료비반2형당뇨병환자병공제혈당적림상료효。방법사선86례비반2형겸혈당공제불가적신진단적당뇨병환자。수궤분위량조，량조환자균진행당뇨병음식공제화괄량운동。재차기출상，대조조환자채용아잡파당연합이갑쌍고치료；치료조환자채용서격렬정연합이갑쌍고치료，치료시간균위12주，분별우치료전후검측량조환자당기화혈홍단백（HbA1c）、공복혈당（ FPG）、찬후2 h혈당（2 h FPG）、감유삼지（TG）、총담고순（TC）、저밀도지단백담고순（LDL-C）、고밀도지단백담고순（HDL-C）、체중지수（BMI）이급이도β세포공능지수（HOMA-β）등지표。결과치료조치료후FPG、2 h FPG 、HbA1c、BMI여대조조치료후비교，차이균유통계학의의（t분별=13.73、6.57、13.17、59.53，P균＜0.05），이HOMA-β비교차이무통계학의의（t=1.10，P＞0.05）；차치료조치료후TC、TG、LDL-C、HDL-C여대조조치료후비교，차이균유통계학의의（t분별=12.26、7.75、4.73、4.03，P균＜0.05）。결론서격렬정연합이갑쌍고능유효강저혈당혈지，병공제환자체중，시침대2형당뇨병비반환자적유효치료방안。
Objective To investigate the clinical effect of sitagliptin combined with metformin for treating obese patients with type 2 diabetes. Methods A total of 86 cases of obesity, poor glycemic controlling and newly diagnosed type 2 diabetes patients were randomly divided into two groups. The patients of two groups were given diabetic diet and took regular exercise. In addition, the control group were treated with acarbose combined with metformin while the treatment group were treated with sitagliptincombined with metformin for 12 weeks. The glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2 h FPG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), body mass index (BMI) and pancreatic β-cell function index (HOMA-β) were detected. Results The FPG, 2 h FPG, HbA1c and BMI of the treatment group after treatment were significantly lower than those of the control group (t=13.73,6.57,13.17,59.53,P<0.05) while the difference of HOMA-β was not statistically significant (t=1.10,P>0.05). The differences of TC, TG, LDL-C and HDL-C after treatment between the treatment group and control group were statistically significant (t=12.26, 7.75, 4.73, 4.03, P<0.05). Conclusion Sitagliptin combined with metformin can effectively reduce blood glucose and lipid and control weight. It is an effective treatment for obese patients with type 2 diabetes.