摘要
目的观察维格列汀与二甲双胍联合治疗对新诊断T2DM患者疗效。方法选取2014年5月至2016年10月于解放军第305医院内分泌科就诊的新诊断T2DM患者80例,随机分为对照组(Con)和治疗组,每组各40例。治疗组予二甲双胍500mg、3次/d+维格列汀50mg、2次/d;对照组予二甲双胍口服500mg、3次/d,共12周。比较两组治疗前后BMI、HbA1c、FPG、2hPG、总TC、TG和LDL-C、同型半胱氨酸(Hcy)、FIns、FC-P等指标的变化,评价胰岛β细胞功能变化情况,并观察不良反应的发生情况。结果 12周后,两组FPG、HbA1c、2hPG均较治疗前降低[(8.93±1.24)vs(7.99±0.97)mmol/L,(8.84±1.20)vs(7.00±0.91)mmol/L],[(8.35±1.09)%vs(7.96±1.01)%,(8.53±1.11)%vs(7.10±0.94)%],[(15.79±2.68)vs(10.51±2.22)mmol/L,(15.53±2.64)vs(9.82±1.91)mmol/L](P<0.05),且治疗组较Con组下降更明显(P<0.05);FIns、胰岛β细胞功能指数(HOMA-β)较治疗前升高[(7.7±2.0)vs(10.2±1.4)mIU/L,(7.9±2.8)vs(11.9±1.0)mIU/L],[(1.6±0.9)vs(2.5±1.0)ng/ml,(1.5±0.7)vs(3.5±1.5)ng/ml],[(59.0±10.9)%vs(62.9±16.9)%,(54.9±16.0)%vs(76.1±18.2)%](P<0.05),治疗组升高较对照组更明显(P<0.05);治疗组在降低胰岛素抵抗指数(HOMA-IR)方面优于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论维格列汀联合二甲双胍能更好地控制新诊断T2DM患者的血糖及BMI,提高IS,同时改善血脂,不增加低血糖发生风险,是新诊断T2DM患者理想治疗方案之一。
Objective To observe the efficacy of vildagliptin and metformin combination therapy in patients with newly diagnosed type 2 diabetes（T2DM）. Methods 80 patients with newly diagnosed T2DM were randomly divided into control group（n=40）treated with metformin 500 mg Tid and treatment group（n=40）treated with metformin 500 mg Tid plus vildagliptin 50 mg Bid for 12 weeks.The changes of body mass index（BMI）,glycosylated hemoglobin（HbA1c）,fasting plasma glucose（FPG）,two-hour postprandial plasma glucose（2 hPG）,total cholesterol（TC）,triglyceride（TG）and low density lipoprotein cholesterol（LDL-C）,homocysteine（Hcy）,insulin（FIns）,c-peptide（FC-P）,βcell function and the occurrence of adverse reactions were compared before and after treatment. ResultsAfter 12 weeks of treatment,the levels of FPG[（8.93±1.24）vs（7.99±0.97）mmol/L,（8.84±1.20）vs（7.00±0.91）mmol/L],HbA1c[（8.35±1.09）% vs（7.96±1.01）%,（8.53±1.11）% vs（7.10±0.94）%]and 2 hPG[（15.79±2.68）vs（10.51±2.22）mmol/L,（15.53±2.64）vs（9.82±1.91）mmol/L]decreased in both two groups（P〈0.05）with more significant decrease in the treatment group（P〈0.05）.The levels of FIns[（7.7±2.0）vs（10.2±1.4）mIU/L,（7.9±2.8）vs（11.9±1.0 mIU/L],FCP[（1.6±0.9）vs（2.5±1.0）ng/ml,（1.5±0.7）vs（3.5±1.5）ng/ml]and HOMA-β[（59.0±10.9）%vs（62.9±16.9）%,（54.9±16.0）% vs（76.1±18.2）%]increased in both two groups（P〈0.05）,with more obvious increase in the treatment group（P〈0.05）.The status of insulin resistance was improved more significantly in treatment group than that in control group（P〈0.05）.The incidence of adverse reactions had no difference between two groups（P〈0.05）. Conclusion The combination therapy with vildagliptin and Metformin can safely control blood glucose in newly diagnosed T2DM,with obvious improvement in weight,insulin sensitivity and lipid,which provides an ideal treatment for patients with T2DM.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2017年第12期1093-1096,共4页
Chinese Journal of Diabetes
关键词
维格列汀
二甲双胍
糖尿病
2型
新诊断
Vildagliptin
Metformin
Diabetes mellitus, type 2
Newly diagnosed
