目的：对西格列汀与格列齐特缓释片联合甘精胰岛素治疗2型糖尿病（T2DM）的疗效和安全性进行比较。方法以83例 T2DM患者为研究对象，按照随机数字表法分为观察组与对照组。观察组使用西格列汀联合甘精胰岛素的用药方案，对照组使用格列齐特缓释片联合甘精胰岛素的用药方案。均治疗16周，监测治疗前后空腹血糖（FPG）、餐后2 h 血糖（2hPG）、糖化血红蛋白（HbA1 c）、空腹胰岛素水平（FIns）、胰岛素抵抗指数（HOMA-IR）、体质量指数（BMI）等指标以及胰岛素用量、不良反应的发生情况。结果治疗后两组的血糖控制均改善，FPG、2hPG、HbA1 c、HOMA-IR 水平较治疗前均明显下降，FIns 均明显升高（P ＜0．05）。治疗后水平比较，对照组 FPG 降低较观察组明显（P ＜0．05），但是观察组2hPG 降低更明显（P ＜0．05）；HbA1 c 达标率、HOMA-IR两组间前后差值比较，差异无统计学意义（P ＞0．05）。观察组的 BMI 水平较对照组下降了6．25％，胰岛素用量减少了12．92％，差异有统计学意义（P ＜0．05）。安全性方面，观察组低血糖的发生率（2．38％），与对照组（9．76％）比较，差异有统计学意义（P ＜0．05）。结论西格列汀联用甘精胰岛素治疗2型糖尿病使血糖控制良好，安全性高。%Objective To investigate the efficacy and safety of the sitagliptin plus glargine insulin or the glicla-zide plus glargine insulin in patients with type 2 diabetes.Methods Eighty-three patients with type 2 diabetes were randomly assigned to 2 group.The observation group was treated with sitagliptin plus glargine insulin,and control group was treated with gliclazide plus glargine insulin.The duration of treatment was 1 6 weeks.FPG,2hPG,HbA1 c,FIns, HOMA-IR,BMI,insulin dosage and adverse events were recorded.Results Glycemic control was improved in both groups.FPG,2hPG,HbA1 c,HOMA-IR were significantly decreased compared to pretreatment,FIns were significantly in-creased(P <0.05),FPG in control group were lower than those in observation group(P <0.05),but 2hPG in observa-tion group were lower than those in control group(P <0.05);HbA1 c targeting rate,HOMA-IR between the two groups had no significant difference.But the BMI level in observation group down by 6.25% compared with control group,also the insulin dose was reduced by 12.92%,the difference was statistically significant.There was significant difference be-tween observation group(2.38%)and control group(9.76%)in the proportion of hypoglycemia too.Conclusion Sita-gliptin combined with glargine had better effect safety in the treatment of type 2 diabetes.
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