恩格列净联合格列齐特治疗2型糖尿病的临床研究  

Clinical study on empagliflozin combined with gliclazide in treatment of type 2 diabetes mellitus

作　　者：张欣荣 薛有平 张凤强 王锐[4] 李蕾[5] ZHANG Xin-rong;XUE You-ping;ZHANG Feng-qiang;WANG Rui;LI Lei(Department of Internal Medicine,Qinhuangdao Military Hospital,Qinhuangdao 066000,China;Department of Clinical Laboratory,Qinhuangdao Military Hospital,Qinhuangdao 066000,China;Department of Endocrinology,Qinhuangdao Military Hospital,Qinhuangdao 066000,China;Department of Endocrinology,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Endocrinology,Xingtai People’s Hospital,Xingtai 054001,China)

机构地区：[1]秦皇岛军工医院内科,河北秦皇岛066000 [2]秦皇岛军工医院检验科,河北秦皇岛066000 [3]秦皇岛军工医院内分泌科,河北秦皇岛066000 [4]秦皇岛市第一医院内分泌科,河北秦皇岛066000 [5]邢台市人民医院内分泌科,河北邢台054001

出　　处：《现代药物与临床》2022年第7期1565-1569,共5页Drugs & Clinic

基　　金：河北省卫健委科研基金项目(20191705)。

摘　　要：目的探讨恩格列净联合格列齐特治疗2型糖尿病的临床效果。方法选取2019年5月—2021年5月秦皇岛军工医院收治的126例2型糖尿病患者,随机分为对照组和治疗组,每组各63例。对照组早餐口服格列齐特缓释片,30 mg/次,1次/d。在对照组基础上,治疗组口服恩格列净片,10 mg/次,1次/d。两组患者连续治疗12周。观察两组患者临床疗效,比较治疗前后两组患者血糖指标、李光伟指数和修正的胰岛β细胞功能指数(MBCI),及血清心钠素(ANP)、内皮素-1(ET-1)、丙二醛(MDA)和基质金属蛋白酶-9(MMP-9)水平。结果治疗后,治疗组降糖有效率(95.24%)较对照组(84.13%)显著提高(P<0.05)。治疗后,两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)比治疗前均显著下降(P<0.05),且以治疗组的降低更显著(P<0.05)。治疗后,两组李光伟指数、MBCI均较治疗前显著升高(P<0.05),且均以治疗组的改善更显著(P<0.05)。相比治疗前,治疗后两组血清ANP水平均显著升高,血清ET-1、MDA和MMP-9水平均显著降低(P<0.05);治疗后,治疗组血清ANP、ET-1、MDA和MMP-9水平均显著好于对照组(P<0.05)。结论恩格列净联合格列齐特治疗2型糖尿病能安全有效且平稳地控制患者血糖水平,改善胰岛β细胞功能,增强胰岛素敏感性。Objective To investigate the clinical effect of empagliflozin combined with gliclazide in treatment of type 2 diabetes mellitus.Methods Patients(126 cases)with type 2 diabetes mellitus in Qinhuangdao Military Hospital from May 2019 to May 2021 were randomly divided into control and treatment group,and each group had 63 cases.Patients in the control group were po administered with Gliclazide Modified Release Tablets,30 mg/time,once daily.Patients in the treatment group were po administered with Empagliflozin Tablets on the basis of the control group,10 mg/time,once daily.Patients in two groups were treated for 12 weeks.After treatment,the clinical evaluation was evaluated,the blood glucose indexes,Li Guangwei index and MBCI,and the levels of ANP,ET-1,MDA and MMP-9 in two groups before and after treatment were compared.Results After treatment,the effective rate of hypoglycemia in the treatment group(95.24%)was significantly higher than that in the control group(84.13%)(P<0.05).After treatment,FPG,2 h PG and HbA1c were significantly decreased in two groups(P<0.05),especially in the treatment group(P<0.05).After treatment,Li Guangwei index and MBCI in two groups were significantly higher than those before treatment(P<0.05),and the improvement in the treatment group was more significant(P<0.05).Compared with those before treatment,the levels of serum ANP were significantly increased and the concentrations of serum ET-1,MDA and MMP-9 were significantly decreased in two groups after treatment(P<0.05),but the levels of serum ANP,ET-1,MDA and MMP-9 in the treatment group were significantly better than those in the control group(P<0.05).Conclusion Empagliflozin combined with gliclazide in treatment of type 2 diabetes mellitus can safely,effectively and smoothly control the blood glucose level of patients,improve isletβ-cell function and enhance insulin sensitivity.

关 键 词：恩格列净片 格列齐特缓释片 2型糖尿病 胰岛Β细胞功能 心钠素 内皮功能 

分 类 号：R977[医药卫生—药品]