CAJ | 학술논문

目的：观察西格列汀联合二甲双胍在2型糖尿病治疗中对胰岛素抵抗及脂联素的影响。方法选取2013年6月至2014年6月医院收治的2型糖尿病患者120例，按照随机数字表法分为治疗组和对照组，各60例。两组患者均给予二甲双胍口服，每次500 mg，每日2次。治疗组加用西格列汀口服(每次100 mg，每日1次)，对照组加用吡格列酮口服(每次15~30 mg，每日1次)，疗程均为12周。结果两组患者治疗后，餐后2 b血糖（2 b PG）、空腹血糖（FPG）、糖化血红蛋白（HbA1C）均较治疗前明显降低（ P<0.05），治疗组FPG及2 b PG降低程度较对照组更明显（ P<0.05）；两组患者胰岛素分泌指数( HOMA－β)均较治疗前明显升高（ P<0.05），且治疗组升高更明显（ P<0.05）；两组患者胰岛素抵抗指数( HOMA－IR )均较治疗前明显下降（ P<0.05），但组间无明显差异（ P>0.05）；两组治疗后脂联素水平均较治疗前明显升高（ P <0.05），治疗组升高更明显（ P <0.05）；两组治疗过程中不良反应发生情况无明显差异（ P>0.05）。结论西格列汀联合二甲双胍治疗2型糖尿病疗效可靠，对胰岛β细胞功能、胰岛素抵抗及脂联素水平具有明显改善作用，不良反应少，值得临床推广。
목적：관찰서격렬정연합이갑쌍고재2형당뇨병치료중대이도소저항급지련소적영향。방법선취2013년6월지2014년6월의원수치적2형당뇨병환자120례，안조수궤수자표법분위치료조화대조조，각60례。량조환자균급여이갑쌍고구복，매차500 mg，매일2차。치료조가용서격렬정구복(매차100 mg，매일1차)，대조조가용필격렬동구복(매차15~30 mg，매일1차)，료정균위12주。결과량조환자치료후，찬후2 b혈당（2 b PG）、공복혈당（FPG）、당화혈홍단백（HbA1C）균교치료전명현강저（ P<0.05），치료조FPG급2 b PG강저정도교대조조경명현（ P<0.05）；량조환자이도소분비지수( HOMA－β)균교치료전명현승고（ P<0.05），차치료조승고경명현（ P<0.05）；량조환자이도소저항지수( HOMA－IR )균교치료전명현하강（ P<0.05），단조간무명현차이（ P>0.05）；량조치료후지련소수평균교치료전명현승고（ P <0.05），치료조승고경명현（ P <0.05）；량조치료과정중불량반응발생정황무명현차이（ P>0.05）。결론서격렬정연합이갑쌍고치료2형당뇨병료효가고，대이도β세포공능、이도소저항급지련소수평구유명현개선작용，불량반응소，치득림상추엄。
Objective To observe tbe influence of sitagliptin combined witb metformin on insulin resistance and adiponectin in tbe treat-ment of type 2 diabetes. Methods Totally 120 patients witb type 2 diabetes admitted to tbe bospital from June 2013 to June 2014 were divided into tbe treatment group and tbe control group according to random number table,60 cases in eacb group. Tbe two groups were treated witb oral metformin 500 mg eacb time,twice a day,on tbis basis tbe treatment group added oral sitagliptin 100 mg,once daily,wbile tbe control group added oral pioglitazone 15-30 mg,once daily. Tbe two groups were treated for 12 weeks. Results After treatment,tbe FPG,2 b PG,HbA1C in tbe two groups were significantly decreased tban before treatment( P < 0. 05),moreover tbe FPG and 2 b PG in tbe treatment group decreased more significantly( P < 0. 05);tbe HOMA-β in tbe two groups were significantly in-creased tban before treatment( P < 0. 05),moreover tbe increase in tbe treatment group was more significant( P < 0. 05);tbe HOMA-IR in tbe two groups were significantly decreased tban before treatment( P < 0. 05),but witbout significantly difference between tbe two groups( P > 0. 05);tbe adiponectin levels in tbe two groups were significantly increased tban before treatment( P < 0. 05),moreover tbe increase in tbe treatment group was more significant( P < 0. 05);tbe occurrence rate of adverse drug reactions during tbe treatment course bad no significant difference between tbe two groups( P > 0. 05). Conclusion Sitagliptin combined witb metformin in tbe treat-ment of type 2 diabetes bas reliable effect and significantly improved effect on insulin resistance and adiponectin levels,bas fewer ad-verse reactions and is wortby of clinical promotion.