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目的探讨二甲双胍联合维格列汀治疗2型糖尿病的临床效果。方法选取2013年6月至2014年6月服用小剂量二甲双胍(日剂量≤500 mg)血糖控制不佳的2型糖尿病患者100例,随机分为观察组和对照组,各50例,对照组应用二甲双胍(1.0 g,bid),观察组患者应用二甲双胍(500 mg,bid)联合维格列汀(50 mg,bid)。比较两组患者治疗前及治疗24周后糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、体质指数(BMI)、血脂、肝肾功能、胰岛素及胰高血糖素样肽-1(GLP-1)等水平变化。结果与治疗前相比,治疗后两组患者FPG、Hb A1c均明显改善(P均<0.05),且治疗后观察组FPG及Hb A1c均低于对照组(P均<0.05)。治疗后,两组患者血脂水平均有轻度下降,但与治疗前比较差异无统计学意义(P均>0.05);与治疗前比较,治疗后对照组患者BMI下降明显(P<0.05),而治疗组则无变化(P均>0.05)。治疗后,两组患者的空腹胰岛素水平均较治疗前下降(P均<0.01),两组治疗后GLP-1均较前有升高(P均<0.01),且观察组改善程度均优于对照组(P均<0.01)。两组均无严重药物不良反应。结论二甲双胍与维格列汀联用不仅可有效降糖,同时耐受性良好,低血糖发生率低。
Objective To investigate the clinical efficacy of metformin combined with vildagliptin in the treatment of type 2 diabetes mellitus. Methods A total of 100 patients with type 2 diabetes mellitus who underwent low-dose metformin (daily dose ≤ 500 mg) control from June 2013 to June 2014 were randomly divided into observation group and control group, 50 cases in each group. The control group Metformin (1.0 g bid) and metformin (500 mg bid) in combination with vildagliptin (50 mg bid) in the observation group. The levels of Hb A1c, fasting blood glucose (FPG), body mass index (BMI), blood lipids, liver and kidney function, insulin and glucagon-like peptide-1 ) And other level changes. Results Compared with that before treatment, FPG and Hb A1c in both groups were significantly improved after treatment (all P <0.05), and the levels of FPG and Hb A1c in the observation group were lower than those in the control group after treatment (all P <0.05). After treatment, the blood lipid levels of both groups decreased slightly, but there was no significant difference between the two groups (P> 0.05). Compared with those before treatment, the BMI of the control group decreased significantly (P <0.05) The treatment group was no change (P all> 0.05). After treatment, the fasting insulin levels of both groups were significantly lower than those before treatment (all P <0.01). The GLP-1 levels in both groups were significantly higher than those before treatment (P <0.01), and the improvement in observation group was better than Control group (all P <0.01). No serious adverse drug reactions in both groups. Conclusions The combination of metformin and vildagliptin can not only hypoglycemic, but also well tolerated and low incidence of hypoglycemia.