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沙格列汀与二甲双胍治疗2型糖尿病的临床对照研究
引用本文:潘珺,郑娟,沈大跃,董华.沙格列汀与二甲双胍治疗2型糖尿病的临床对照研究[J].实用药物与临床,2014(5):649-652.
作者姓名:潘珺  郑娟  沈大跃  董华
作者单位:嘉善县第一人民医院内一科,浙江嘉善314100
摘    要:目的探讨沙格列汀与二甲双胍治疗2型糖尿病(T2DM)的临床疗效、安全性以及用药依从性。方法选择我院收治的2型糖尿病患者为研究对象,随机分为沙格列汀组和二甲双胍组,分别给予沙格列汀和二甲双胍控制血糖,观察并记录两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(PG2h)、糖化血红蛋白(HbA1c)、低血糖发生率、肝肾功能、体重变化情况,同时对两组患者用药的依从性进行对比分析。结果两组总有效率比较差异无统计学意义(P>0.05),但沙格列汀组显效率明显高于二甲双胍组,差异有统计学意义(P<0.05)。治疗12周后,沙格列汀组患者FBG、PG2h、HbA1c水平均较治疗前明显改善(P<0.01);二甲双胍组FBG、PG2h较治疗前明显改善(P<0.01),但HbA1c水平较治疗前改善不明显(P>0.05)。沙格列汀组治疗后FBG、PG2h、HbA1c改善程度均明显优于二甲双胍组,差异均有统计学意义(P<0.01)。两组患者治疗前后血谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、血肌酐(Scr)等肝肾功能检查指标差异均无统计学意义(P>0.05),两组治疗12周后体重指数与治疗前比较差异无统计学意义(P>0.05)。两组患者用药期间不良反应发生率比较差异无统计学意义(P>0.05),且症状较轻微,均经对症处理后缓解。格列汀组患者用药依从性明显高于二甲双胍组,差异有统计学意义(P<0.05)。结论沙格列汀能有效控制2型糖尿病患者的血糖,降低糖化血红蛋白水平,同时对肝肾功能、体重等无明显影响,且不良反应少,但由于沙格列汀为新药,临床试验随访时间较短,其远期疗效、安全性以及患者的耐药性仍需进行长期的大样本研究加以证实。

关 键 词:沙格列汀  二甲双胍  2型糖尿病  空腹血糖  糖化血红蛋白

Clinical comparative research of onglyza and metformin on type 2 diabetes
PAN Jun,ZHENG Juan,SHEN Da-yue,DONG Hua.Clinical comparative research of onglyza and metformin on type 2 diabetes[J].Practical Pharmacy and Clinical Remedies,2014(5):649-652.
Authors:PAN Jun  ZHENG Juan  SHEN Da-yue  DONG Hua
Institution:(Department of Internal Medicine, The First People's Hospital of Jiashan County, Zhejiang 314100, China)
Abstract:Objective To investigate the clinical efficacy,safety and medication compliance of onglyza and metformin treatment for type 2 diabetes. Methods Type 2 diabetes patients in our hospital were chose as the research object,and were randomly divided into onglyza group and metformin group,the fasting blood glucose(FBG),2 h postprandial blood glucose( PG2h),glycosylated hemoglobin( HbA1c),the incidence of hypoglycemia,liver and kidney function,weight change of the two groups were recorded and compared and the medication compliance of the two groups were analyzed. Results The total effective rate of the two groups had no significant difference(P &gt; 0. 05),but the significant efficiency of onglyza group was obviously higher than that of metformin group,there was significant difference between the two groups(P &lt; 0. 05). After 12 weeks treatment,the FBG,PG2h and HbA1c level of onglyza group were significantly improved than before treatment( P &lt; 0. 01);The FBG and PG2h level of metformin group were significantly improved than before treatment(P &lt; 0. 01),but the HbA1c level improvement was not obvious(P &gt;0. 05). The FBG,PG2h,HbA1c improvement degree of onglyza group were significantly superior to that of metformin group,there was significant difference between the two groups( P &lt; 0. 01). The liver and kidney function of the two groups had no significant difference(P &gt; 0. 05),and the body mass index of the two groups had no significant change after the 12 weeks treatment,there was no difference between the two groups( P &gt; 0. 05). The adverse reactions incidence during the medication of the two groups had no significant difference between the two goups(P &gt; 0. 05),and the symptoms was mild,they were all eased up after symptomatic treatment. The medication compliance of onglyza group was significantly higher than that of metformin group,the difference was significant(P &lt; 0. 05). Conclusion Onglyza can effectively control the blood
Keywords:Onglyza  Metformin  Type 2 diabetes  Fasting plasma glucose  Glycosylated hemoglobin
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