利拉鲁肽联用二甲双胍治疗初发2型糖尿病患者有效性及安全性分析

目的：探讨利拉鲁肽联合二甲双胍治疗初发2型糖尿病的疗效及安全性。方法：选取近1年内初次诊断为2型糖尿病的患者46例,按随机数字表法分为格列齐特缓释片组（对照组）和利拉鲁肽组（观察组）,每组各23例。对照组给予格列齐特缓释片60 mg,每日晨起空腹服用,同时加二甲双胍0.5 g,2次/d治疗;观察组给予利拉鲁肽0.6 mg,1次/d（第1周）、1.2 mg,1次/d（第2周）,同时加二甲双胍0.5 g,2次/d治疗。治疗12周后检测两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白、腹部内脏脂肪厚度（VAT）,比较两组间各项指标的变化。结果：治疗12周后,两组的空腹血糖、餐后2 h血糖、糖化血红蛋白较治疗前均明显下降,差异均有统计学意义（P〈0.05）;且观察组的VAT较治疗前明显下降,差异均有统计学意义（P〈0.05）。治疗后,与对照组相比,观察组的上述4项指标均明显降低,差异均有统计学意义（P〈0.05）,且无低血糖及其他不良反应发生。结论：利拉鲁肽联合二甲双胍缓释片治疗初发2型糖尿病,疗效及安全性均优于格列齐特缓释片。

The Effectiveness and Safety Analysis of the Combination of Liraglutide and Metformin on Type 2 Diabetic Mellitus

Objective： To study the therapeutic effects of the combination of Liraglutide and Metformin on type 2 diabetic mellitus（T2DM）. Method： 46 patients incipiently diagnosed with T2DM were enrolled and randomly divided into the Gliclazide sustained-release tablet group（the control group） and the Liraglutide group（the observation group）, 23 cases in each group. The control group was treated with GSRT（60 mg qm） plus Metformin（500 mg bid）, while the observation group was treated with Liraglutide（0.6 mg qd） in the first week, and liraglutide（1.2 mg qd） plus Metformin（500 mg bid） from the second week, respectively treatment of 2 times a day. The levels of fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin,abdominal visceral fat thickness were detected after treatment for 12 weeks.The changes of various indexes between the two groups were compared. Result： After 12 weeks intervention, the levels of fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin reduced significantly in both groups（P〈0.05）, and the VAT decreased in the observation group as well（P〈0.05）. And the observation group had more significant reduction in all the four indexes compared with the control group after treatment（P〈0.05）, and had no hypoglycemia or other adverse reactions. Conclusion： The therapeutic effect and security of combining Metformin with Liraglutide on T2DM is better than with GSRT.