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采用双盲随机平行对照的研究方法,选择单用二甲双胍(≥1500mg)血糖控制不佳(7.0%≤HbA_(1C)≤10.0%)的超重或肥胖(BMI≥24kg/m~2)T_2DM患者62例,随机加用西格列汀片100mg/qd(n=32,A组)或伏格列波糖片0.2mg/tid(n=30,B组)治疗16周。结果(1)各组内BMI、Wt、FPG、2hPPG、HbA_(1C)均较治疗前下降(P<0.05);(2)治疗16周后,两组间BMI、Wt、FPG、2hPPG、HbA_(1C)无统计学意义(P>0.05),但A组糖代谢指标下降略明显;(3)两组治疗后HOMA-%B有统计学意义(P<0.05),同时在低血糖及消化道不良反应发生率方面均存在统计学差异(P<0.05)。结论应用西格列汀/伏格列波糖联合二甲双胍,治疗单用二甲双胍血糖控制不佳的超重/肥胖T_2DM患者,均可降低空腹血糖、餐后血糖、HbA_(1C)和BMI,特别是可明显降低餐后血糖,但西格列汀组糖代谢指标下降略明显,可能与西格列汀可改善胰岛功能有关;且其低血糖及消化道不良反应发生率均低,服用简单方便,患者依从性好。
A double-blind, randomized, parallel-controlled study was conducted to select patients with overweight or obesity (BMI≥24kg / m ~ 2) T_2DM with glycemic control of only metformin (≥1500mg) with poor glycemic control (7.0% ≤HbA_ (1C) ≤10.0% Patients were randomized to receive sitagliptin 100 mg / qd (n = 32, group A) or voglibose 0.2 mg / tid (n = 30, group B) for 16 weeks. Results (1) BMI, Wt, FPG, 2hPPG and HbA_ (1C) in each group were significantly lower than those before treatment (P <0.05); (2) After 16 weeks of treatment, BMI, Wt, FPG, (1) There was no significant difference between the two groups (P> 0.05), but there was a slight decrease of glucose metabolism index in group A; (3) HOMA-% B after treatment was statistically significant The incidence of adverse reactions were statistically significant (P <0.05). Conclusions Sitagliptin / vgolebolol combined with metformin can reduce fasting blood glucose, postprandial blood glucose, HbA_ (1C) and BMI in patients with overweight / obesity T_2DM with glycemic control alone. Significantly lower postprandial blood glucose, but the sitagliptin group significantly decreased glucose metabolism index, may be related to the reduction of sitagliptin islet function; and its low incidence of hypoglycemia and gastrointestinal adverse reactions are low, easy to take, patients Good compliance.