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目的对于单用盐酸二甲双胍片治疗血糖控制仍不达标[糖化血红蛋白(HbA1c)>7%]的2型糖尿病患者,观察联合使用沙格列汀或阿卡波糖的疗效及安全性。方法选取口服盐酸二甲双胍片而血糖仍未达标的糖尿病患者100例分为2组,沙格列汀组和阿卡波糖组各50例。2组患者在继续服用二甲双胍的基础上分别联合使用沙格列汀或阿卡波糖,均治疗24周,观察并记录2组患者治疗前后糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(PG2h)、体重指数(BMI)、低血糖发生率、不良反应发生率以及肝肾功能检查指标。结果 2组治疗后HbA1c、FBG、PG2h均较联合治疗前下降,而沙格列汀组下降程度高于阿卡波糖组,差异具有统计学意义(P<0.05)。同时2组均未发生低血糖反应,阿卡波糖组胃肠道不良反应较沙格列汀组多。结论对于二甲双胍控制不佳的2型糖尿病患者,联用沙格列汀较联用阿卡波糖降糖效果更佳,胃肠道不良反应更少,而低血糖发生率相当。
Objective To observe the efficacy and safety of combined use of sitagliptin or acarbose for type 2 diabetes mellitus (DMH)> 7% with glycerophosphate (HbA1c)> 7%, which is not met with metformin hydrochloride alone. Methods One hundred patients with metformin hydrochloride tablets whose blood glucose was not yet reached the standard were divided into two groups, 50 patients in the saxagliptin group and acarbose group. The two groups were treated with metformin on the basis of continued use of saxagliptin or acarbose, were treated for 24 weeks, observed and recorded before and after treatment in two groups of patients with HbA1c, fasting blood glucose (FBG), postprandial 2 h blood glucose (PG2h), body mass index (BMI), the incidence of hypoglycemia, the incidence of adverse reactions and liver and kidney function tests. Results The levels of HbA1c, FBG and PG2h decreased in both groups before and after treatment, while those in saxagliptin group were lower than those in acarbose group (P <0.05). At the same time, no hypoglycemic reaction occurred in the two groups. The side effects of acarbose in the gastrointestinal tract were more than those in the saxagliptin group. Conclusions For patients with type 2 diabetes with poorly controlled metformin, combination saxagliptin is more effective than hypothyroidism with acarbose, with fewer gastrointestinal side effects and a similar incidence of hypoglycaemia.