盐酸吡格列酮并用磺酰脲类药物治疗2型糖尿病的临床效果研究  

Evaluation on the Effectiveness and Safety of Pioglitazone Hydrochloride Combined with Sulfonylurea in the Treatment of Type 2 Diabetes

作　　者：郎鲁洁 LANG Lujie(Department of Pharmacy,Second Hospital of Traditional Chinese Medicine,Huangdao District,Qingdao,Shandong Province,266400,China)

机构地区：[1]山东省青岛市黄岛区第二中医医院药剂科,山东青岛266400

出　　处：《中国药物滥用防治杂志》2021年第2期179-183,共5页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:研究2型糖尿病患者采用盐酸吡格列酮和磺酰脲类药物治疗的临床效果。方法:选择2019年12月到2020年9月本院收治的90例已采用双胍类与磺脲类药物治疗的2型糖尿病患者为研究对象,按照随机数表法分成对照组和试验组,每组各45例。对照组予安慰剂治疗,试验组予盐酸吡格列酮(卡司平)治疗。比较两组不同阶段剂量稳定的条件下空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、餐后2 h胰岛素、胰岛素抵抗指数和不良事件发生率。结果:治疗8周与16周时试验组空腹血糖(7.49±1.56)mmol/L、(7.79±1.40)mmol/L及治疗16周时餐后2 h血糖(8.19±1.53)mmol/L、糖化血红蛋白(7.77±1.19)%低于对照组,差异有统计学意义(t=3.002、3.057、1.999、2.837,P<0.05);两组治疗16周后胰岛素指标比较,差异无统计学意义(P>0.05);试验组不良事件发生率高于对照组(62.22%>48.89%),差异无统计学意义(χ^(2)=1.620,P>0.05)。结论:2型糖尿病患者口服降糖药(双胍类+磺脲类)、运动及饮食治疗不佳时联用盐酸吡格列酮安全有效,能进一步改善代谢控制,提高胰岛素敏感性,值得临床推广。Objective:To study the clinical effects of pioglitazone hydrochloride and sulfonylurea treatment in patients with type 2 diabetes.Methods:The 90 patients with type 2 diabetes who had been treated with biguanides and sulfonylureas,who were admitted to our hospital from December 2019 to September 2020,were selected as the research subjects.They were divided into control group and test group according to the random number table method.45 cases in each group.The control group was treated with placebo,and the test group was treated with pioglitazone hydrochloride(carspine).The fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,2 h postprandial insulin,insulin resistance index and the incidence of adverse events were compared between the two groups under the condition of stable dose at different stages.Results:The fasting blood glucose(7.49±1.56)mmol/L,(7.79±1.40)mmol/L of the test group at 8 weeks and 16 weeks of treatment,and the 2 h postprandial blood glucose(8.19±1.53)mmol/L,glycation at 16weeks of treatment Hemoglobin(7.77±1.19)%was lower than the control group,the difference was statistically significant(t=3.002,3.057,1.999,2.837,P<0.05);the two groups were treated for 16 weeks after the insulin index,the difference was not statistically significant(P>0.05);the incidence of adverse events in the experimental group was higher than that in the control group(62.22%>48.89%),and the difference was not statistically significant(χ^(2)=1.620,P>0.05).Conclusion:Oral hypoglycemic drugs(biguanides+sulfonylureas)in patients with type 2 diabetes,combined with pioglitazone hydrochloride are safe and effective when exercise and diet are not good,which can further improve metabolic control and increase insulin sensitivity,and it is worthy of clinical promotion.

关 键 词：安全性 胰岛素 糖尿病 盐酸吡格列酮 不良事件 

分 类 号：R587.1[医药卫生—内分泌]