单用二甲双胍控制不佳的2型糖尿病患者联用沙格列汀或格列美脲的临床研究  

Clinical research of metformin combined with saxagliptin or glimepiride in patients with type 2 diabetes mellitus inadequately controlled with metformin

作　　者：陈光明[1] 胡艳飞[1] 楼雪勇[1] 

机构地区：[1]金华市中心医院内分泌科,浙江金华321000

出　　处：《中国临床药理学杂志》2015年第19期1910-1912,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察单用二甲双胍血糖控制不佳的2型糖尿病患者分别联用沙格列汀与格列美脲的临床疗效和安全性。方法 60例单用二甲双胍血糖控制仍不达标的2型糖尿病患者,随机分为试验组和对照组各30例。2组均保持原来二甲双胍剂量和用法不变,试验组口服沙格列汀5 mg,每天1次;对照组早餐前口服格列美脲1-4 mg,每天1次,2组均治疗12周。观察治疗前后患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（Hb A1c）、血脂和空腹胰岛素（FINS）、胰岛β细胞功能指数（HOMA-β）等指标变化情况。结果治疗后,2组患者FPG、2 h PG及Hb A1c显著低于治疗前（P〈0.05）,但组间差异无统计学意义。治疗后,试验组与对照组相比,FINS、HOMA-β明显改善（P〈0.05）。2组均无严重不良反应,试验组轻度低血糖发生率较对照组低（P〈0.05）。结论沙格列汀在单用二甲双胍血糖控制不佳的2型糖尿病患者中与格列美脲的降糖疗效相当,但沙格列汀可更显著改善胰岛β细胞功能,且低血糖发生率更低。Objective To observe the effect and safety of metformin combined with saxagliptin or glimepiride in patients with type 2 diabetes mellitus inadequately controlled with metformin alone. Methods Sixty patients with type 2 diabetes mellitus inadequately controled by metformin alone were randomly divided into trial group and control group,30 patients in each group. The two groups maintain the original dose of metformin and usage unchanged,patients in trial group were given oral saxagliptin 5 mg,once a day,and the patients in control group were treated with glimepiride 1- 4 mg once daily before breakfast. The treatment lasted 12 weeks. The data of fasting plasma glucose（ FPG）,2 h postprandial plasma glucose（ 2 h PG）,hemoglobin A1c（ Hb A1c）,lipids weight,fasting insulin（ FINS）,homeostasis model assessment of β- cell function（ HOMA- β） were recorded and compared between the two groups.Results The serum levels of FPG,2 h PG and Hb A1 c were significantly decreased in two groups after treatment（ P〈0. 05）,but had no significant differences between the two groups. Compared with control group,the levels of FINS and HOMA- β statistically increased after treatment in the trial group（ P〈0. 05）. There was no serious adverse reaction inboth groups during the treatment,the incidence of mild hypoglycemia was significantly less in trial group（ P〈0. 05）.Conclusion The blood glucose control of saxagliptin is comparable to glimepiride,but saxagliptin showed a better effect on the improvement of β- cell function and decrease of the risk of hypoglycaemia.

关 键 词：2型糖尿病 二甲双胍 沙格列汀 空腹血糖 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌] R977.15[医药卫生—内科学]