摘要
目的:探讨胰岛素泵联合二甲双胍或吡格列酮短期强化治疗2型糖尿病的临床疗效。方法:选取2015年6月—2016年12月中山大学附属第三医院粤东医院内分泌与代谢病学科收治的糖化血红蛋白(Hb A1c)≥9%的2型糖尿病患者150例,以随机数字表法分为三组,每组50例,分别采用单纯胰岛素泵(A组)、胰岛素泵联合二甲双胍(B组)和胰岛素泵联合吡格列酮(C组)治疗,所用胰岛素均为门冬胰岛素。比较治疗2周后三组患者的血糖、Hb A_1c水平,血糖达标时间,胰岛素日剂量及低血糖发生情况。结果:治疗前,三组患者空腹血糖、餐后2 h血糖及Hb A1c等指标水平的差异均无统计学意义(P>0.05)。治疗后,三组患者各血糖指标均较治疗前明显改善,差异均有统计学意义(P<0.05);B、C组患者空腹血糖、餐后2 h血糖改善情况明显优于A组,差异均有统计学意义(P<0.05),但B、C组之间的差异无统计学意义(P>0.05);三组患者Hb A_1c水平的差异无统计学意义(P>0.05);B、C组患者血糖达标时间明显短于A组,胰岛素日剂量明显低于A组,差异均有统计学意义(P<0.05),但B、C组之间的差异无统计学意义(P>0.05)。A、B及C组患者低血糖发生率分别为2%(1/50)、6%(3/50)及4%(2/50),三组的差异无统计学意义(P>0.05)。结论:胰岛素联合二甲双胍或吡格列酮短期强化治疗2型糖尿病,可提高治疗效果,减少胰岛素抵抗及胰岛素使用量。
OBJECTIVE： To probe into the clinical efficacy of insulin pump combined with metformin or pioglitazone in short-term intensive treatment of type 2 diabetes. METHODS： 150 patients with type 2 diabetes with ≥9% of Hb A1 c admitted into Yuedong Hospital of the Third Affiliated Hospital of Zhongshan University from Jun. 2015 to Dec. 2016 were selected and divided into three groups via random number table,with 50 in each group,which were respectively given insulin pump（ group A）,insulin pump combined with metformin（ group B） and insulin pump combined with pioglitazone（ group C）,all the applied insulin was insulin aspart. Levels of blood glucose and Hb A_1 c,required times of blood glucose control,daily doses of insulin and incidences of hypoglycemia of three groups at 2 weeks after treatment were compared. RESULTS： Before treatment,there were no statistical significance in differences of fasting blood glucose（ FBG）,2 h postprandial blood glucose（ PBG） and Hb A1 c level among three groups（ P 0. 05）. After treatment,all indices of blood glucose of three groups had been significantly improved,with statistically significant differences（ P 0. 05）; FBG and 2 h PBG of group B and group C had been improved more significantly than group A,with statistically significant difference（ P 0. 05）,while there was no statistical significance between the two groups（ P 0. 05）; there were no statistical significance in differences of Hb A_1 c levels among three groups（ P 0. 05）; the required time of blood glucose control of group B and group C were significantly shorter than that of the group A,with significantly lower daily dose of insulin than that of group A,with statistically significant differences（ P 0. 05）,while there were no statistical significances between the group B and group C（ P 0. 05）. Incidences of hypoglycemia of the three groups were respectively 2%（ 1/50）,6%（ 3/50） and 4%（ 2/50）,the differences had no statistical significances（ P 0. 05）.CONCLUSIONS�
作者
李姗姗
李远
李冬玲
LI Shanshan, LI Yuan, LI Dongling(Dept. of Endocrinology and Metabolic Diseases, Yuedong Hospital of the Third Affiliated Hospital of Zhongshan University, Guangdong Meizhou 514000, Chin)
出处
《中国医院用药评价与分析》
2018年第3期317-319,322,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
梅州市科技计划项目(No.2015B073)
