超重和肥胖的2型糖尿病患者二联口服药物治疗的临床疗效分析  

Clinical Efficacy Analysis of Dual Oral Drug Therapy in Overweight and Obese Patients with Type 2 Diabetes Mellitus

作　　者：陈建霞[1] 代凌[1] 邓川芬 王玲 刘敏 李正宇 CHEN Jianxia;DAI Ling;DENG Chuanfen;WANG Ling;LIU Min;LI Zhengyu(Department of Endocrinology,Luxian People's Hospital,Luzhou,Sichuan Province,646100 China)

机构地区：[1]泸州市泸县人民医院内分泌科,四川泸州646100

出　　处：《糖尿病新世界》2022年第20期64-68,76,共6页Diabetes New World Magazine

摘　　要：目的比较超重和肥胖的2型糖尿病(type 2 diabetes mellitus,T2DM)患者在使用二甲双胍缓释片基础上联合恩格列净或维格列汀治疗的疗效及安全性。方法回顾性收集泸州市泸县人民医院2020年5月—2021年4月治疗期间,诊断为T2DM合并超重或肥胖的患者149例,在给予二甲双胍缓释片单药降血糖治疗效果不佳的情况下,给予二联治疗,分别联合恩格列净组(74例)和维格列汀组(75例)治疗24周,并评估治疗前后糖化血红蛋白(HbA1c),以及空腹血糖(FPG)、餐后2 h血糖(2 hPG)、体质指数(BMI)等其他相关代谢指标以及不良反应发生情况。结果治疗后,两组血糖水平均优于治疗前,但组间差异无统计学意义(P>0.05);恩格列净组体质量及腰围均优于维格列汀组,差异有统计学意义(P<0.05);两组血压、血脂、UACR指标、HOMA-IR指标均优于治疗前,但组间差异无统计学意义(P>0.05);恩格列净组的总不良反应为10例,多于维格列汀组的2例,组间比较差异有统计学意义(χ^(2)=4.024,P<0.05)。结论恩格列净、维格列汀分别联合二甲双胍缓释片治疗超重或肥胖的T2DM均可降低患者的血糖水平,恩格列净组较维格列汀组在降低体质量方面更具优势,更适合超重和肥胖的T2DM。Objective To compare the efficacy and safety of metformin hydrochloride sustained-release tablets combined with empagliflozin or vildagliptin in overweight and obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 149 patients diagnosed as T2DM complicated with overweight or obesity in Luxian People’s Hospital from May 2020 to April 2021 were retrospectively collected.In the case of poor hypoglycemic effect of metformin hydrochloride sustained-release tablets alone,the patients were given dual treatment,and divided them into the empagliflozin group(74 cases)and the vildagliptin group(75 cases).After 24 weeks of treatment,glycated hemoglobin A1c(HbA1c),fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),body mass index(BMI),other related metabolic indicators and incidence of adverse reactions were evaluated before and after treatment.Results After treatment,the blood glucose levels of the two groups were better than those before treatment,but there was no significant difference between the two groups(P>0.05).The body weight and waist circumference of the lengliflozin group were better than those of the vildagliptin group,and the difference was statistically significant(P<0.05).The blood pressure,blood lipid,UACR index and HOMA-IR index of the two groups were better than those before treatment,but there was no significant difference between the two groups(P>0.05).The total adverse reactions in the empagliflozin group were 10cases,more than 2 cases in the vildagliptin group,and the difference between the two groups was statistically significant(χ^(2)=4.024,P<0.05).Conclusion The treatment of overweight or obese T2DM with empagliflozin and vildagliptin combined with metformin hydrochloride sustained-release tablets can reduce the blood glucose level of patients,and the empagliflozin group has more advantages than the vildagliptin group in reducing body mass,which is more suitable for overweight and obese T2DM.

关 键 词：恩格列净 维格列汀 二甲双胍 超重或肥胖 T2DM患者 体质量 

分 类 号：R587.1[医药卫生—内分泌]