德谷门冬双胰岛素联合司美格鲁肽强化治疗肥胖2型糖尿病的临床效果  

Clinical effect of intensive treatment of obese type 2 diabetes with Degu asparagus insulin and semaglutide

作　　者：刘萍莉 高逸凡 钱晓翠 李雨潇 Liu Pingli;Gao Yifan;Qian Xiaocui;Li Yuxiao(Department of Nephrology,Rugao Hospital of Traditional Chinese Medicine,Nantong 226500,China)

机构地区：[1]如皋市中医院肾脏内分泌科,江苏南通226500 [2]如皋市中医院骨科,江苏南通226500

出　　处：《海军医学杂志》2025年第2期189-193,共5页Journal of Navy Medicine

基　　金：江苏省科技项目(BE2020427)。

摘　　要：目的评估德谷门冬双胰岛素联合司美格鲁肽强化治疗肥胖2型糖尿病患者的临床效果。方法选取2020年5月至2023年5月在如皋市中医院就诊的92例肥胖2型糖尿病患者作为研究对象,按随机数字表法分为治疗组和对照组,每组46例。治疗组接受德谷门冬双胰岛素联合司美格鲁肽治疗,对照组接受司美格鲁肽治疗。观察2组患者治疗前、治疗4周后的临床指标,包括糖脂代谢指标(空腹血糖、糖化血红蛋白、果糖胺、餐后2 h血糖及总胆固醇水平)、血糖波动情况(血糖标准差、餐后血糖波动幅度、24 h平均血糖)、胰岛素抵抗指数及内脏脂肪指数、抗氧化指标[丙二醛(MDA)、脂质过氧化物(LPO)、超氧化物歧化酶(SOD)、氧磷脂酶1(PON1)]及不良反应发生情况。结果治疗4周后,相较于对照组,治疗组空腹血糖、糖化血红蛋白、果糖胺、餐后2 h血糖和总胆固醇水平降低(P<0.05),血糖标准差、餐后血糖波动幅度和24 h平均血糖均减少(P<0.001),胰岛素抵抗和内脏脂肪指数均降低(P<0.001),MDA和LPO水平均降低(P<0.001),SOD和PON1水平均升高(P<0.001)。2组患者胃肠道不良反应、低血糖和肝脏损伤的发生率比较差异无统计学意义(P>0.05)。结论德谷门冬双胰岛素联合司美格鲁肽强化治疗可有效改善代谢指标,是肥胖2型糖尿病综合治疗的一种有效方案。Objective To evaluate the clinical effect of intensive treatment of obese patients with type 2 diabetes with Degu asparagus insulin and semaglutide.Methods A total of 92 obese patients with type 2 diabetes who were admitted to Rugao Hospital of Traditional Chinese Medicine from May 2020 to May 2023 were selected and randomly divided into two groups by randomnumber table method,with 46 cases in each group.The treatment group received Degu asparagus insulin and semaglutide,and the control group was treated with semaglutide.Glucose and lipid metabolism indicators(fasting blood glucose,glycated hemoglobin,fructosamine,2-hour postprandial blood glucose,and total cholesterol),blood glucose fluctuations(standard deviation of blood glucose,amplitude of postprandial blood glucose fluctuations,24-hour average blood glucose),insulin resistance index,visceral fat index,antioxidant indicators(malondialdehyde[MDA],lipid peroxide[LPO],superoxide dismutase[SOD],and paraoxonase-1[PON1]),and adverse reactions were observed before and after 4 weeks of treatment.Results After 4 weeks of treatment,the treatment group showed a significant improvement in glucose and lipid metabolism compared to the control group,including decreased fasting blood glucose,glycated hemoglobin,fructosamine,2-hour postprandial blood glucose,and total cholesterol(P<0.05).In addition,the treatment group showed significant reduction in the standard deviation of blood glucose,amplitude of postprandial blood glucose fluctuations,and 24-hour average blood glucose.Insulin resistance and visceral fat index were also significantly decreased in the treatment group(P<0.05).The decreases in MDA and LPO and the increases in SOD and PON1 indicated that the treatment group had better antioxidant capacity(P<0.001).There was no significant difference in the incidence of gastrointestinal adverse reactions,hypoglycemia,or liver damage between the two groups(P>0.05).Conclusion Degu asparagus insulin combined with semaglutide can effectively improve metabolic indicators of obes

关 键 词：肥胖2型糖尿病 德谷门冬双胰岛素 司美格鲁肽 血糖 胰岛素水平 

分 类 号：R587.1[医药卫生—内分泌]