津力达颗粒联合二甲双胍治疗初发2型糖尿病患者的疗效分析

目的观察津力达颗粒联合二甲双胍对初发2型糖尿病（T2DM）患者血糖控制的影响，并探讨其可能机制。方法将88例初发T2DM患者随机分为2组，每组44例。试验组予以津力达颗粒联合二甲双胍进行治疗，对照组予以二甲双胍进行治疗。随访16周，检测治疗前后2组患者空腹血糖（FPG）、餐后2小时血糖（2tLPG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）及脂肪因子水平，并计算治疗前后胰岛素抵抗指数（HOMA—IR）及体质量指数（BMI）。结果治疗后，2组HbAlc、FI）G、2hPG及BMI均较治疗前明显降低，差异有统计学意义；试验组与对照组HbAlc≤6．5％的患者分别为34例（82．9％）和24例（61．5％），2组比较差异有统计学差异。治疗后，2组FINS、HOMA—IR及瘦素水平均较治疗前明显下降，而脂联素水平明显升高，且试验组各指标降低及升高幅度略大于对照组。2组不良反应均轻微，未见低血糖事件及明显肝肾功能损害。结论对于新诊断2型糖尿病患者，滓力达颗粒与二甲双胍联用可协同降低血糖，提高血糖达标率，2者对血浆瘦素、脂联素水平的调控是其纠正胰岛素抵抗的可能机制。

Effect of Jinlida granule combined with metformin on treatment of patients with initial type 2 diabetes

Objective To explore the influence of Jinlida granule combined with metformin on blood glucose control of patients with initial type 2 diabetes mellitus （T2DM）. Methods 88 pa- tients with initial T2DM were randomly divided into trail group and control group, 44 cases in each group. The trial group was treated with Jinlida granule combined with metformin, while the control group was treated with metforrnin. All the patients were followed up for 16 weeks. Levels of fasting blood glucose （FPG）, 2 h postprandial glucose （2 hPG）, glycosylated hemoglobin （HbAlc）, fast- ing insulin （FINS） and adipokines were detected before and after treatment in both groups, and homeostasis model assessment- insulin resistance index （HOMA- IR） and body mass index （BMI） were calculated as well. Results After treatment, the levels of HbAlc, FPG, 2 hPG and BMI in both groups decreased significantly. The ratio of patients with HbAlc~6.5 % in trial group was 82.9% （34/44）, which was significantly higher than 61.5% （24/44） in the control group. After treatment, the levels of FINS, HOMA- IR and leptin decreased significantly, while the adiponectin increased significantly. Increased and decreased degrees of all the indexes in the trial group were slightly larger than those in the control group. Adverse reactions in both groups were mild, and no hypoglycemic events and conspicuous liver and kidney function damages were observed. Conclusion For the patients with initial T2DM, Jinlida granule combined with metformin can decrease the blood glucose and improve the qualified rate of blood glucose . and Coordinate regulation of plasma leptin and adiponectin may be the possible mechanism of correcting resistance.