罗格列酮联合二甲双胍治疗初发2型糖尿病疗效与安全性评价

目的探讨罗格列酮与二甲双胍联合治疗初发2型糖尿病的疗效,并评价联合用药的安全性。方法 180例初发2型糖尿病患者随机分为罗格列酮组、二甲双胍组和罗格列酮联合二甲双胍组,每组60例,分别给予罗格列酮、二甲双胍和罗格列酮＋二甲双胍,共治疗24周。观察3组糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2h血糖（2hBG）、胰岛素（BG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（HOMA-IAI）、体重指数（BMI）、总胆固醇（TC）、三酰甘油（TG）,并观察3组的不良反应情况。结果 3组治疗后FBG、2hBG、FINS、HbA1c、TC及TG均较治疗前显著下降（P〈0.05或〈0.01）;罗格列酮联合二甲双胍组FBG、2hBG、BMI较单用罗格列酮及二甲双胍显著下降（P〈0.05）,FINS较二甲双胍组显著下降（P〈0.05）;罗格列酮联合二甲双胍组HOMA-IAI升高程度较其他2组更明显（P〈0.05）。结论罗格列酮联合二甲双胍治疗初发2型糖尿病较二者单用疗效好,可作为理想的用药选择。

The evaluation of therapeutic effect and safety of rosiglitazone combined with metformin on incipient type 2 diabetes

Objective To investigate the therapeutic effect of rosiglitazone combined with metformin on incipient type 2 diabetes,and to evaluate the safety. Methods A total of 180 patients with incipient type 2 diabetes were randomly divided into rosiglitazone group,metformin group and rosiglitazone combined with metformin group,with 60 patients in each group. The patients in three groups were respectively administered with rosiglitazone,metformin and rosiglitazone plus metformin for 24 weeks. The levels of HbA1c,FBG,2h BG,FINS,HOMA-IR,HOMA-IAI,BMI,TC,TG and adverse reactions （ ADR） in the three groups were determined and observed. Results After treatment,the levels of FBG,2 h BG,FINS,HbA1c,TC and TG in three groups were significantly decreased,as compared with those before treatment （ P 〈0. 05 or P〈 0. 01）. However,the levels of FBG,2 h BG and BMI in rosiglitazone combined with metformin group were significantly decreased,as compared with those in the other two groups （ P〈 0. 05） ,and FINS was significantly decreased,as compared with that of metformin group （ P 〈0. 05）. The increase in HOMA-IAI in rosiglitazone combined with metformin group was also significant diference,as compared with that in the other two groups （ P 〈0. 05） ; the incidence of ADR in rosiglitazone combined with metformin group was also lower than that of the other two groups. Conclusion Rosiglitazone combined with metformin shows a better effect on incipient type 2 diabetes and low ADR,which can serve as an ideal therapy for type 2 diabetes.