磷酸西格列汀联合二甲双胍治疗2型糖尿病的临床疗效

目的观察对接受药物初始治疗或近12周内未接受任何降糖药物治疗的2型糖尿病患者应用磷酸西格列汀和二甲双胍联合治疗的有效性及安全性。方法对接受药物初始治疗或近12周内未接受降糖药物治疗的90例2型糖尿病患者采用随机数字表法分为磷酸西格列汀联合二甲双胍组、二甲双胍单药治疗组、磷酸西格列汀单药治疗组,比较治疗16周后磷酸西格列汀联合二甲双胍组分别较单药治疗组对糖化血红蛋白(Hb A_1c)、空腹血糖(FBG)及餐后2 h血糖(PBG)的影响及服药期间不良反应的发生情况。结果治疗16周后,磷酸西格列汀和二甲双胍联合治疗组与磷酸西格列汀单药治疗组相比患者的FBG、PBG及Hb A_1c水平均差异有统计学意义(P0.05)。联合治疗组与二甲双胍单药治疗组相比,患者的FBG有所下降,但两组之间差异无统计学意义(P0.05),而联合治疗组所致的PBG及Hb A_1c水平的下降,差异有统计学意义(P0.05)。治疗期间各组患者低血糖的发生率相似,磷酸西格列汀和二甲双胍联合治疗组的腹泻、恶心、呕吐等胃肠道不良事件的发生率与各单药治疗组相比差异均无统计学意义(P0.05)。各治疗组均未有肝肾功能异常、胰腺炎等不良事件发生。结论磷酸西格列汀联合二甲双胍组在降糖疗效方面均优于二甲双胍及磷酸西格列汀单药治疗组,且低血糖、胃肠道等不良反应的发生率低。

Clinical effect of phosphate sitagliptin combined with metformin in treatment of type 2 diabetes mellitus

Objective To observe the efficacy and safety of phosphoric acid combined with metformin in pa-tients with type 2 diabetes mellitus untreated or without any therapy in 12 weeks.Method Ninety type 2 diabetes pa-tients had not received prior treatment or without any therapy in 12 weeks for their diabetes were randomly divided into sitagliptin phosphate combined with metformin group,metformin group,phosphate sitagliptin group.Three groups were compared after 16weeks of glycosylated hemoglobin (HbA1 c),fasting blood glucose (FBG),2 hour postprandial blood glucose (PBG)and side effect of medicine.Result After 16 weeks of treatment,The FBG,PBG and HbA1 c in phos-phoric acid sitagliptin combined with metformin group were lower than those in phosphate sitagliptin group (P <0.05). Compared with the metformin group,the PBG and HbA1 c decreased significantly in combined treatment group;,FBG de-creased in combined treatment group but the differences between the two groups was not significant (P >0.05).The in-cidence rate of hypoglycemia,diarrhea,nausea and vomiting gastrointestinal adverse event were similar among three groups,there was not statistically significant(P >0.05).None of the patients had abnormality in liver and kidney func-tion,acute pancreatitis and other adverse events.Conclusion Sitagliptin phosphate combined with metformin is superior to metformin and phosphate sitagliptin monotherapy in the hypoglycemic effects with low hypoglycemia and gastrointesti-nal adverse reactions.