摘要
目的观察西格列汀联合二甲双胍治疗2型糖尿病(T2DM)伴非酒精性脂肪肝(NAFLD)的临床疗效和安全性。方法将94例2型糖尿病伴非酒精性脂肪肝患者随机分为对照组和试验组,每组47例。对照组口服二甲双胍0.5 g,每天2次;试验组在对照组的基础上,晨起口服西格列汀0.1 g,每天1次。2组均持续用药4个月。比较2组患者的临床疗效,胰岛素抵抗指数(HOMA-IR),胰岛β细胞功能(HOMA-β),血糖及肝功能,并观察2组患者的药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为82.98%(39例/47例)和61.70%(29例/47例),差异有统计学意义(P<0.05)。试验组和对照组HOMA-IR分别为1.06±0.08和1.13±0.11,HOMA-β分别为85.70±10.07和65.83±7.20,空腹血糖(FPG)分别为(6.07±0.76)和(6.66±0.80)mmol·L^(-1),餐后2 h血糖(2 h PG)分别为(8.63±1.07)和(9.36±1.40)mmol·L^(-1),糖化血红蛋白(Hb A1c)分别为(5.84±0.69)%和(6.39±0.77)%,谷丙转氨酶(ALT)分别为(30.76±3.77)和(38.37±3.72)mmol·L^(-1),谷草转氨酶(AST)分别为(34.06±4.04)和(40.20±4.69)mmol·L^(-1),差异均有统计学意义(均P<0.05)。对照组出现便秘2例,腹痛4例,上呼吸道感染4例,药物不良反应发生率为21.28%(10例/47例);试验组出现便秘3例,腹痛2例,上呼吸道感染3例,药物不良反应发生率为17.02%(8例/47例),差异无统计学意义(P>0.05)。结论西格列汀联合二甲双胍对2型糖尿病伴非酒精性脂肪肝患者的疗效优于单用二甲双胍,能够降低HOMA-IR,提高HOMA-β水平。
Objective To evaluate the clinical effect of sitagliptin combined with metformin in the treatment of patients of type 2 diabetes （T2DM） with nonalcoholic fatty liver disease （NAFLD）. Methods Ninety - four patients with T2DM and NAFLD were randomly divided into control group and treatment group, with 47 cases in each group. Control group was treated with mefformin 0. 5 g, oral, bid. Treatment group was orally given sitagliptin 0. 1 g on the basis of control group, qd. Both groups were treated for 4 months. The clinical efficacy, homeostasis mo- del assessment of insulin resistance （ HOMA - IR）, islet β cell function （ HOMA -β） , blood glucose, liver function and adverse drug reactions in two group were compared in two groups. Results After treatment,the total effective rates in treatment group and control group were 82. 98% （39 cases/47 cases） and 61.70% （29 cases /47 cases ）, with significant difference （P 〈 0. 05 ）. HOMA -IR in treatment group and control group were 1.06 0. 08 and 1.13±0. 11 ,HOMA - β were 85.70±10. 07 and 65.83±7.20, fasting blood glucose（FPG） were （6. 07 ± 0. 76 ） and （6.66± 0. 80） mmol·L- 1,2 h postprandial blood glucose （ 2 h PG） were （ 8.63 ±1.07 ） and （9.36 ± 1.40） mmol· L - 1, glycosylated hemoglobin （ HbA1 c ） were （ 5.84 ± 0. 69 ） % and （ 6. 39± 0. 77 ） %, ala- nine aminotransferase （ALT） were （30. 76 ± 3.77 ） and （38.37 ± 3.72） mmol · L-1, aspartate aminotransferase （AST） were （34. 06 ± 4. 04） and （40. 20 ± 4. 69 ） mmol· L- 1, all with significant difference （ all P 〈 0. 05 ）. There were 2 cases of constipation, 4 cases of abdominal pain,4 cases of upper sense in control group, with the incidence of 21.28% （ 10 cases/47 cases）. There were 3 cases of constipation, 2 cases of abdominal pain,3 cases of upper sense intreatment group, with the incidence of 17.02% （ 8 eases/47 cases） , with no significant difference （ P 〉 0.05 ）. Conclusion The clinical effect of
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2018年第5期518-520,527,共4页
The Chinese Journal of Clinical Pharmacology
基金
河南省高等学校青年骨干教师资助计划基金资助项目(2014GGJS-187)
