吡格列酮治疗2型糖尿病临床疗效观察

目的比较吡格列酮和二甲双胍在降血糖、降血脂、降血压及改善胰岛素敏感性的作用。方法采用随机对照研究，共选择60例2型糖尿病患者，分为两组，对照组（30例）给予二甲双胍500mg，口服，每日2次；试验组（30例）给予吡格列酮30mg，口服，每日1次。疗程均为12周，观察两组治疗前后血糖、血脂、血压、胰岛素等指标的变化。结果治疗后两组血糖、糖化血红蛋白均明显下降（P〈0．01），组间比较差异无统计学意义（P〉0．05）。试验组胰岛素、c肽均明显下降（P〈0．01），对照组餐后2h胰岛素下降（P〈0．05）。试验组三酰甘油、游离脂肪酸明显下降，高密度脂蛋白一胆固醇较治疗前升高（P均〈0．01）。对照组血脂各项较治疗前明显变化（P均〈0．01），两组间比较，总胆固醇和低密度脂蛋白-胆固醇变化比较差异有统计学意义（P〈0．05），但两组不良反应发生率比较差异无统计学意义（P〉0．05）。结论吡格列酮和二甲双胍具有相似的降血糖、调脂作用，而吡格列酮还有改善外周组织胰岛素敏感性及降血压的作用。

Comparision of effect of pioglitazone and metformin in treatment of type 2 diabetes mellitus

Objective To compare the effect of pioglitazone and metformin in dereasing blood glucose, blood fat and improving insulin sensitivity. Methods The parallel randomized control clinical trial was used. Sixty patients with type 2 diabetes meltitus were divided into treatment group and control group. The patients of control group took metformin 500 mg,po, bid for 12 weeks. The patients of treatment group took pioglitazone 30 mg, po, qd for 12 weeks. The changes of blood glucose ,blood fat and insulin before and after treatment between two groups were observed. Results The blood glucose and glycosy -lated hemoglobin（HbAlc） after treatment in two groups significantly reduced（ P 〈0.01 ）. Insulin and C -peptide reduced in treatment group （P 〈 0.01 ）. As to control group, postprandial insulin reduced （ P 〈 0.05 ）. The triglycerides and the free fat acid reduce in treatment group. However, the high - density lipoprotein cholesterol was improved in two groups（ P 〈0. 01 ）. Besides,the variable value of lower -density lipoprotein cholesterol and total cholesterol in control group was obviously lower than that in treatment group （ P 〈 0.05）. There was no difference in adverse reaction rate between two groups （ P 〉 0. 05 ）. Conclusions Pioglitazone and mefformin are equal efficient in decreasing blood glucose and regulating blood lipid. Moreover, pioglitazone exerts significant effects on improving insulin sensitivity and reducing blood pressure.