二甲双胍、吡格列酮联合应用治疗肥胖2型糖尿病患者的疗效观察

目的观察二甲双胍、吡格列酮联合应用治疗新诊断肥胖2型糖尿病（T2DM）的疗效。方法选取71例新诊断肥胖他DM患者随机分成两组，治疗组25例给予二甲双胍500mg、2次／d，吡格列酮30mg、1次／d联合治疗；对照组包括二甲双胍组（M组）和吡格列酮组（P组），M组24例给予二甲双胍500mg、2次／d治疗；P组22例给予吡格列酮30mg、1次／d治疗患者。所有治疗疗程12周，观察空腹血糖（FPG）及餐后2h血糖（2hPG）、空腹胰岛素（FINS）及餐后2h胰岛素（P2hINS）和糖化血红蛋白（HbA1c）的变化情况。结果三组患者在治疗后FPG、2hPG、HbA1c、FINS、P2hINS均明显下降。M组和P组疗效相似；治疗组在减低患者胰岛素水平、改善糖代谢紊乱方面均优于M组和P组。结论联合应用二甲双胍和吡格列酮治疗，可作为经过单一使用二甲双胍或吡格列酮治疗血糖控制仍然不良的肥胖T2DM患者选用的治疗的方法之一。

Clinical observation of metformin combined with pioglitazone in treating newly diagnosed obesity type 2 diabetes patients

Objective To investigate the therapeutic effect of metformin combined pioglitazone on the newly diagnosed obesity type 2 diabetes(T2DM).Methods 71 patients with newly diagnosed obesity type 2 diabetes were randomly divided into two groups.25 patients in treatment group were treated by metformin(500 mg twice daily) and pioglitazone(30 mg once daily).The control group involved metformin group and pioglitazone group,24 patients in metformin group were given metformin(500 mg twice daily),22 patients in pioglitazone group were given pioglitazone(30 mg once daily).The treatment lasted for 12 weeks.The change of fasting plasma glucose(FPG),2 hour postprandial plasma glucose(2hPG),HbA_(1C),fasting plasma insulin(FINS) and 2 hour postprandial plasma insulin(P2hINS) levels were determined.Results After the treatment,the level of FPG,2hPG,HbA_(1C),FINS and P2hINS decreased significantly in three groups.The results showed that metformin group and pioglitazone group had similar curative effect,the treatment group was better in decreasing level of insulin and improving glucose metabolism disturbance as compared with metformin group and pioglitazone group.Conclusion Metformin combined pioglitazone is one of the choices in the newly diagnosed obesity T2DM patients whose glycemia was poorly controlled with single medication.