目的　观察胰岛素增敏剂罗格列酮合用二甲双胍治疗 2型糖尿病 (2 DM)的临床疗效和安全性。方法　应用治疗前后自身对照的方法 ,37例经双胍类以及磺脲类加双胍类治疗 ,血糖控制不佳的 2 DM患者 ,改用罗格列酮 4mg口服 ,每日 1次 ,同时给二甲双胍 2 5 0～ 5 0 0mg口服 ,每日 3次 ,观察治疗前和治疗 12周后空腹血糖以及餐后 2h的血糖 (FBG、PBG)、胰岛素 (FINS、PINS)、糖化血红蛋白(HbAlc)以及胰岛素敏感指数 (ISI)和胰岛素抵抗指数(IRI) ,监测血脂 ,肝肾功能和血常规等。结果　治疗 12周后与治疗前相比较 ,FBG、PBG、FINS、PINS下降 ,ISI增加 ,IRI降低 ,差异有显著性 ;HbAlc和血脂变化不大 ,副作用轻微 ,肝肾功能无损害。结论　罗格列酮明显改善外周组织对胰岛素的敏感性 ,加二甲双胍合用治疗 2 DM降血糖疗效确切 ,临床应用安全性好 Objective To observe the clinical efficacy and safety of insulin sensitizer rosiglitazone combined with metformin in the treatment of type 2 diabetes mellitus (DM). Methods 37 cases of DM patients treated with biguanide and sulphonylurea plus biguanide with poor glycemic control were treated with rosiglitazone 4 mg orally once a day and metformin 2 The levels of fasting blood glucose (FBG), fasting blood glucose (FBG), insulin (FINS, PINS), HbA1c and insulin sensitivity were measured before treatment and 12 weeks after treatment. Index (ISI) and insulin resistance index (IRI), monitoring blood lipids, liver and kidney function and blood routine. Results Compared with those before treatment, FBG, PBG, FINS, PINS decreased, ISI increased, IRI decreased, the difference was significant; HbAlc and lipid did not change much, side effects were mild, liver and kidney function was not damaged. Conclusions Rosiglitazone significantly improves the sensitivity of peripheral tissues to insulin. The combination of metformin and 2-DM is effective in reducing blood glucose and has good clinical application