达格列净联合二甲双胍治疗2型糖尿病的临床疗效

目的 探讨达格列净联合二甲双胍对2型糖尿病的临床治疗效果。方法 选取2016年1月-2017年6月西安市第一医院收治的2型糖尿病患者97例，按治疗方法分为对照组48例、观察组49例。所有患者均给予1个月的导入治疗，结束后对照组使用二甲双胍治疗，观察组在此基础上联合达格列净治疗。两组均连续治疗3个月，每2周对患者进行一次电话随访，每1个月对患者进行一次门诊随访。比较两组治疗前后血糖、血流动力学相关指标的变化，比较两组治疗期间不良反应的发生情况。结果 两组治疗前空腹血糖（FBG）、糖化血红蛋白（HbA1c）、餐后2 h血糖（2hPG）间无显著差异，治疗后两组以上指标均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。两组治疗前视网膜中央动脉（CRA）、睫状后动脉（PCA）的收缩期峰值流速（PSV）、舒张末期血流速度（EDV）、阻力指数（RI）间无显著差异，治疗后以上指标均显著升高（P<0.05），且观察组较对照组更显著（P<0.05）。治疗期间，观察组的不良反应发生率是18.37%，与对照组的18.75%间无显著差异。结论 达格列净联合二甲双胍对2型糖尿病的疗效确切，可显著降低FBG、HbA1c、2hPG水平，改善球后动脉血流动力学相关指标，值得临床应用推广。

Clinical efficacy of dapagliflozin combined with metformin in type 2 diabetes mellitus

Objective To explore the clinical efficacy of dapagliflozin combined with metfotmin on type 2 diabetes mellitus. Methods Selected 97 patients with type 2 diabetes mellitus in our hospital from January 2016 to June 2017. All patients were divided into control group (n=48) and observation group (n=49). All patients were given 1 month of induction therapy, the control group were treated with metformin after the induction therapy, the observation group were treated with dapagliflozin on the basis of control group. The blood glucose, hemodynamics and the incidence of adverse reactions were compared between two groups. Results There was no significant difference between FBG, HbA1c and 2hPG before treatment in both groups. After treatment, the above two indexes were significantly lower (P<0.05), and the observation group was more obvious than the control group (P<0.05). There were no significant differences in PSV, EDV and RI between CRA and PCA before treatment in both groups, and the above indexes were significantly increased after treatment (P<0.05), and the observation group was more significant than the control group (P<0.05). During the treatment, The incidence of adverse reactions of the observation group (18.37%) was not significantly different from that in the control group (18.75%). Conclusions Dapagliflozin combined with metformin has definite curative effect on type 2 diabetes mellitus, which can significantly reduce the levels of FBG, HbA1c and 2hPG, and improve hemodynamics of the posterior arteries related indicators, which is worthy of promotion in clinical application.