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1、二甲雙胍和吡格列酮對2型糖尿病降糖療效的觀察
?。壅菽康挠^察二甲雙胍和吡格列酮對2型糖尿?。═2DM)患者降糖的療效。方法80例血糖控制不良的T2DM患者在原治療方案下,隨機(jī)分為2組:二甲雙胍組,給予鹽酸二甲雙胍500 mg,2次/d,和模擬吡格列酮片2片,1次/d;吡格列酮組,給予吡格列酮30 mg,1次/d,和模擬二甲雙胍片1片,2次/d。各組療程均為12周。結(jié)果2組在治療后空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血紅蛋白(HbA1C)較用藥前明顯降低。用藥8周和12周時,吡格列酮組比二甲雙胍組2hPG下降更明顯。結(jié)論二甲雙胍和吡格列酮均能有效地降低F
2、PG、2hPG和HbA1C,在用藥8~12周時,吡格列酮在降低2hPG方面優(yōu)于二甲雙胍組。
[關(guān)鍵詞]2型糖尿??;二甲雙胍;吡格列酮
Effect of meformin and pioglitazone on reducing blood sugar of type 2 diabetes
[Abstract]ObjectiveTo investigate the effect of meformin and pioglitazone on reducing blood sugar of T2DM patients.Methods80 T2DM patients wi
3、th less controlled blood sugar were divided into two groups; the patients in meformin group were treated with meformin HCl 500 mg,twice a day,together with 2 tablets of the simulated pioglitazone,once a day; the patients in group pioglitazone were treated with pioglitazone 30 mg,once a day,together
4、with 1 tablet of the simulated meformin,twice a day.The treatment of both groups was 12 weeks.ResultsAfter the treatment,the FPG,ZHPG and H6A1C in the second group were obviously lower than before the treatment.After 8 weeks and 12 weeks of receiving above treatments,ZHPG of the patients in pioglita
5、zone group decreased more clearly than meformin group.ConclusionWhile meformin,pioglitazone were taken by the patients from 8 weeks to 12 weeks,the effect of pioglitazone group on decreasing ZHPG is superior to that of meformin group.
[Key words]type 2 diabetes mellitus;meformin;pioglitazone
6、
2型糖尿?。═2DM)的病理生理改變主要是胰島素抵抗(IR)和胰島素分泌不足。二甲雙胍和吡格列酮均具有降低IR、改善糖代謝的作用[1],本研究進(jìn)行隨機(jī)雙盲對照試驗,比較兩種藥物對T2DM患者的降糖效果。
1資料與方法
1.1一般資料年齡35~65歲的T2DM患者80例,單純飲食和運(yùn)動治療,F(xiàn)PG 7.8~14.0 mmol/L和(或)2hPG≥11.1 mmol/L者,未用胰島素,無胃腸道、肝、腎、造血系統(tǒng)等主要臟器嚴(yán)重疾患。
1.2方法采用雙盲雙模擬隨機(jī)對照研究的方法將80例受試者分為2組,每組40例。二甲雙胍組早餐后口服鹽酸二甲雙胍500 mg和模擬吡格
7、列酮片2片,晚餐后口服二甲雙胍500 mg。吡格列酮組早餐后口服鹽酸吡格列酮30 mg和模擬二甲雙胍片1片,療程均為12周。用藥前及用藥后2周、4周、8周、12周各隨訪1次,觀察臨床表現(xiàn),測定FPG、2hPG、HbA1C。
1.3統(tǒng)計學(xué)方法用SPSS 12.0軟件分析,計量資料以均數(shù)標(biāo)準(zhǔn)差(xs)表示,用t檢驗。分類資料用χ2檢驗。
2結(jié)果
二甲雙胍組中有3例失訪,4例因不良反應(yīng)退出;吡格列酮組有3例失訪,5例因不良反應(yīng)退出。這兩組入選對象、年齡、性別構(gòu)成比、體重指數(shù)(BMI)、糖尿病病程、血壓、入選時FPG、2hPG、HbA1C 、合并用藥等差異均無顯著性。
8、
2.1兩組用藥前后血糖、HbA1C變化情況二甲雙胍組FPG和2hPG于用藥2周后顯著降低,至12周時FPG和2hPG分別平均降低(2.82.1)mmol/L(25.6%)和(3.53.9)mmol/L(19.3%),HbA1C降低(1.72.0)%。吡格列酮組FPG和2hPG于用藥2周后顯著降低,至12周時最低,分別平均降低(2.11.4)mmol/L(20.9%)和(5.22.6) mmol/L(30.0%),HbA1C降低(1.31.7)%。比較用藥后二甲雙胍和吡格列酮組的FPG和HbA1C下降值和下降百分率,差異均無顯著性,但是用藥8周和12周時,兩組2hPG下降百分率的差異有顯著性。見表1表1用藥前后血糖水平的變化(略)注:用藥后與用藥前比較,*P<0.05