维生素D3联合格列美脲治疗2型糖尿病的疗效观察

目的探讨维生素D_3片联合格列美脲片治疗2型糖尿病的临床疗效。方法选取2016年2月—2017年1月在襄阳市中心医院接受治疗的2型糖尿病患者86例,依据治疗方法差别分为对照组与治疗组,每组各43例。对照组初始口服格列美脲片,1 mg/次,1次/d,根据血糖调整用药,最大维持剂量不超过6 mg/d。治疗组在对照组的基础上口服维生素D_3片,1片/次,2次/d。两组患者均治疗4周。比较两组治疗前后临床疗效、血糖指标变化以及内环境稳态模型评估-β(HOMA-β)、HOMA-IR和25(OH)D_3水平。结果治疗后,对照组和治疗组的总有效率分别为81.40%和95.35%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(Hb Alc)及空腹胰岛素(FINS)水平均显著下降(P0.05);且治疗组血糖指标变化水平显著好于对照组(P0.05)。治疗后,两组HOMA-β及25(OH)D_3水平显著升高,并且HOMA-IR水平明显降低,同组比较差异具有统计学意义(P0.05);且治疗组上述指标改善情况显著优于对照组,两组比较差异具有统计学意义(P0.05)。结论维生素D_3片联合格列美脲片治疗2型糖尿病具有较好的临床效果,可有效改善胰岛素抵抗和提高敏感性,具有一定的临床推广应用价值。

Clinical observation of vitamin D3 combined with glimepiride in treatment of type 2 diabetes mellitus

Objective To investigate the clinical effect of Vitamin D3 Tablets combined with Glimepiride Tablets in treatment of type 2 diabetes mellitus.Methods Patients (86 cases) with type 2 diabetes mellitus in Xiangyang Central Hospital from February 2016 to January 2017 were divided into control and treatment groups based on different treatments, and each group had 43 cases. Patients in the control group werepoadministered with Glimepiride Tablets, 1 mg/time, once daily, which was adjusted according to blood sugar, and the maximum maintenance dose did not exceed 6 mg/d. Patients in the treatment group werepoadministered with Vitamin D3 Tablets on the basis of the control group, 1 tablet/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy, the changes of blood glucose indicators, and HOMA-β, HOMA-IR, and 25(OH)D3 levels in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control and treatment groups were 81.40% and 95.35%, respectively, and there was difference between two groups (P < 0.05). After treatment, the FPG, 2 h PG, HbAlc and FINS levels two groups was significantly decreased (P < 0.05). And the changes of blood glucose indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the HOMA-β and 25(OH)D3 levels in two groups were significantly increased, but HOMA-IR level was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05).Conclusion Vitamin D3 Tablets combined with Glimepiride Tablets has good clinical effect in treatment of type 2 diabetes mellitus, and can effectively improve insulin resistance and sensitivity, which has a certain clinical application value.