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目的观察三种不同方式联合磺酰脲类药物治疗继发性失效的2型糖尿病患者,进一步探讨其短期疗效。方法磺酰脲类药物继发性失效的2型糖尿病患者66例,随机分成三组,A组(睡前NPH加二甲双胍再加拜唐苹)、B组(睡前NPH加二甲双胍)、C组(睡前NPH加二甲双胍再加达美康)。疗程3个月,治疗前、后测定FBG、PBG、Fc、Pc、CH、TG、LDL-TC、HDL-TC。结果A、B、C组,FBG、PBG、CH、TG、LDL-TC均明显降低,HDL-TC均明显升高(P<0.05),Fc、Pc差异无统计学意义(P>0.05)。FBG下降的幅度C组>A组,C组>B组,PBG下降幅度A组>C组>B组。结论睡前小剂量应用中效胰岛素联合口服降糖药治疗SFS的2型糖尿病患者安全有效,可以改善胰岛素抵抗,以NPH加二甲双胍再加达美康联合降空腹血糖效果最佳,以NPH加二甲双胍再加拜唐苹联合降餐后血糖效果最优。
Objective To investigate the short-term efficacy of three different ways combined with sulfonylurea in the treatment of type 2 diabetes patients with secondary failure. Methods Sixty-six patients with type 2 diabetes mellitus secondary to sulfonylurea were randomly divided into three groups: group A (NPH plus metformin plus beitangpit), group B (NPH plus metformin before bedtime), group C (Bedtime NPH plus metformin plus Deltameconazole). The course of treatment was 3 months. FBG, PBG, Fc, Pc, CH, TG, LDL-TC and HDL-TC were measured before and after treatment. Results The levels of FBG, PBG, CH, TG and LDL-TC in group A, B and C were significantly decreased, but HDL-TC were significantly increased (P <0.05). There was no significant difference between Fc and Pc (P> 0.05). The extent of decrease of FBG in C group> A group, C group> B group, PBG decrease group A> C group> B group. Conclusion Low dose of moderate dose of insulin before treatment combined with oral hypoglycemic agents in type 2 diabetes mellitus patients with SFS is safe and effective, can improve insulin resistance, with NPH plus metformin plus dipymegln combined to reduce fasting blood glucose best, with NPH plus metformin Plus Beitang Ping combined meal after blood glucose optimal effect.