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目的探讨瑞格列奈联合甘精胰岛素治疗糖尿病肾病的疗效和安全性。方法选择血糖控制不佳且合并有糖尿病肾病的患者120例,随机平均分为2组,实验组60例予以瑞格列奈联合甘精胰岛素治疗,对照组60例单独注射优泌林70/30,疗程均为12周,将治疗前后2组患者空腹血糖、餐后2h血糖、糖化血红蛋白、血尿素氮和肌酐等指标进行比较,并以此判断两种治疗方法在疗效和安全性方面的优劣。结果实验组患者和对照组患者经治疗后FBG、2hBG、HbAlc比较结果发现,两组治疗方案治疗前后均有差异且差异具有显著性(P<0.05)。两组组间差异无统计学意义(P>0.05)。生化指标比较,治疗前后所有患者的UAER,TC发生显著性改变差异有统计学意义(p<0.05),BUN,Cr的改变差异无统计学意义(P>0.05)。而以上指标两组组间差异均无统计学意义(P>0.05)。治疗组有4名患者出现低血糖症状,对照组15名患者出现低血糖症状,治疗组明显低于对照组,两组低血糖发生率差异具有统计学意义(p<0.05)。结论瑞格列奈联合甘精胰岛素治疗糖尿病肾病的效果肯定,安全性比单用优泌林70/30高,值得在临床上推广。
Objective To investigate the efficacy and safety of repaglinide combined with insulin glargine in the treatment of diabetic nephropathy. Methods A total of 120 patients with poor control of blood glucose and diabetic nephropathy were randomly divided into two groups. 60 patients in the experimental group were treated with repaglinide and insulin glargine, while the other 60 patients in the control group were treated with 30/50 , The course of treatment was 12 weeks, the fasting blood glucose, postprandial blood glucose 2h, glycosylated hemoglobin, blood urea nitrogen and creatinine were compared between the two groups before and after treatment to determine the efficacy and safety of the two treatment methods inferior. Results The results of FBG, 2hBG and HbAlc in experimental group and control group after treatment showed that there were significant differences between the two groups before and after treatment (P <0.05). There was no significant difference between the two groups (P> 0.05). There were significant differences in biochemical indexes between UAER and TC in all patients before and after treatment (p <0.05), but there was no significant difference between BUN and Cr (P> 0.05). The above indicators between the two groups showed no significant difference (P> 0.05). Hypoglycemic symptoms were found in 4 patients in the treatment group and hypoglycemia in 15 patients in the control group, which were significantly lower in the treatment group than in the control group. The difference in the incidence of hypoglycemia between the two groups was statistically significant (p <0.05). Conclusion The effect of repaglinide combined with insulin glargine in the treatment of diabetic nephropathy is better than that of monocrotaline alone in the treatment of diabetic nephropathy. It is worth to be popularized clinically.