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目的:观察并对比二肽基肽酶-Ⅳ抑制剂西格列汀、胰岛素增敏剂罗格列酮分别联合降糖药物二甲双胍治疗老年2型糖尿病(T2DM)的临床疗效。方法:入选2010年4月-2012年10月间我科收治的老年T2DM患者70例,并随机单盲分为A(n=36)、B(n=34)两组,A组患者予西格列汀+二甲双胍方案,B组予罗格列酮+二甲双胍方案,服药12周后对比两组血糖水平、临床疗效并药物不良反应。结果:①两组患者服药12周后,血糖指标均较治疗前明显下降(P<0.05),A组患者2hPG水平明显低于B组水平(P<0.05)。②A组患者显效率(50.0%)、总体有效率(91.7%)略高于B组(38.2%、85.3%),差异不具有统计学意义(P>0.05)。③两组患者均未出现严重药物不良反应,两组不良反应发生率(19.4%vs.26.5%)无统计学差异(P>0.05)。结论:两种用药方案均是治疗老年T2DM的有效方案,西格列酮+二甲双胍方案较之罗格列酮+二甲双胍方案在临床疗效中具备比较优势,尤其是对降低餐后血糖优势明显。
Objective: To observe and compare the clinical efficacy of dipeptidyl peptidase-Ⅳ inhibitor sitagliptin and insulin sensitizer rosiglitazone in combination with metformin in the treatment of senile type 2 diabetes mellitus (T2DM). Methods: A total of 70 elderly T2DM patients admitted to our department from April 2010 to October 2012 were randomly divided into two groups: A (n = 36) and B (n = 34) The combination of ketamine and metformin in group B was given rosiglitazone plus metformin. After 12 weeks of treatment, the blood glucose level, clinical efficacy and adverse drug reactions were compared between the two groups. Results: ① After 12 weeks of treatment, the blood glucose levels of two groups were significantly lower than those before treatment (P <0.05). The level of 2hPG in group A was significantly lower than that in group B (P <0.05). ② The effective rate (50.0%) and overall effective rate (91.7%) in group A were slightly higher than that in group B (38.2%, 85.3%). The difference was not statistically significant (P> 0.05). ③ No serious adverse drug reactions occurred in both groups. The incidence of adverse reactions in both groups was no significant difference (19.4% vs.26.5%) (P> 0.05). CONCLUSION: Both of the two regimens are effective regimens for the treatment of T2DM in elderly patients. Compared with the rosiglitazone + metformin regimen, the regimen of siglitazone + metformin has comparative advantages in clinical efficacy, especially for reducing postprandial blood glucose.