目的 探讨初发2型糖尿病患者采用磷酸西格列汀与二甲双胍联合治疗的临床效果.方法 选取2021年8月—2022年8月莆田市第一医院药学科收治的80例初发2型糖尿病患者为研究对象,按照随机数表法分为对照组(n=40)和观察组(n=40),对照组采用二甲双胍治疗,观察组采用磷酸西格列汀与二甲双胍联合治疗,对比两组的临床总有效率、治疗前后的血糖水平、胰岛功能指标和不良反应发生率.结果 观察组临床总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组在空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial plasma glucose,2 hPG)和糖化血红蛋白(glycated hemoglobin,HbA1c)水平均低于对照组,差异有统计学意义(P<0.05);观察组空腹胰岛素(fasting insulin,FINS)、餐后2h胰岛素(2 hours postprandial insulin,2 hPINS)水平均低于对照组,胰岛β细胞功能指数(homeostasis model assessment-β,HOMA-β)高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05).结论 在二甲双胍的基础上联合磷酸西格列汀治疗,不仅能显著提高初发2型糖尿病患者的治疗效果,合理控制其血糖水平,还能调节其胰岛功能,安全性良好,临床可进一步推广.
Objective To investigate the clinical effect of sitagliptin phosphate combined with metformin in patients with initial type 2 diabetes.Methods A total of 80 patients with newly diagnosed type 2 diabetes admitted to the De-partment of Pharmacy of Putian First Hospital from August 2021 to August 2022 were selected as the study objects,and were divided into control group(n=40)and observation group(n=40)according to random number table method.The control group was treated with metformin,and the observation group was treated with sitagliptin phosphate com-bined with metformin.The total clinical effective rate,blood glucose level,islet function index and incidence of ad-verse reactions were compared between the two groups.Results The total clinical effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treat-ment,the levels of fasting blood glucose(FBG),2-hour postprandial plasma glucose(2 hPG)and glycated hemoglobin(HbA1c)in the observation group were lower than those of the control group,and the differences were statistically sig-nificant(P<0.05).The levels fasting insulin(FINS)and 2 hours postprandial insulin(2 hPINS)in observation group were lower than those in control group,the islet β cell function index(HOMA-β)of the the observation group was higher than that of control group,and the difference was statistically significant(P<0.05).There was no significant dif-ference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Combined treatment with sitagliptin phosphate on the basis of metformin can not only significantly improve the therapeutic effect of patients with initial type 2 diabetes,reasonably control their blood glucose level,but also regulate their islet function,with good safety,and can be further promoted in clinical practice.