不同方式联合药物治疗2型糖尿病继发性失效的疗效探讨

目的观察三种不不同方式联合磺酰脒类药物治疗继发性失效的2型糖尿病患者。进一步探讨其短期疗效。方法磺酰脲炎药物继发性失效的2型糖尿病患者66例，随机分成三组，A组（睡前NPH加二甲双胍再加拜唐苹）、B组（睡前NPH加二甲双胍）．C组（睡前NPH加二甲双胍再加达美康）。疗程3个月，治疗前、后测定FBG、PBG、Fc、Pc、CH、TG、LDL-TC、HDL-TC。结果A、B、C组，FBG、PBG、CH、TG、LDL-TC均明显降低，HDL-TC均明显升高（P〈0．05），Fc、Pc差异无统计学意义（P〉0．05）。FBG下降的幅度C组〉A组，C组〉B组，PBG下降幅度A组〉C组〉B组。结论睡前小剂量应用中效胰岛素联合口服降糖药治疗SFS的2型糖尿病患者安全有效，可以改善胰岛素抵抗，以NPH加二甲双胍再加达美康联合降空腹血糖效果最佳，以NPH加二甲双胍再加拜唐苹联合降餐后血糖效果最优。

Effects of different combination therapy on secondary failure of sulfonylurea in type 2 diabetes mellitus

Objective To observe effects of three different combination therapies secondary failure of sulfonylurea in type 2 diabetes mellitus.Methods Sixty-six cases of type 2 diabetes mellitus of SFS were randomly divided into three groups:A(bedime NPH insulin plus metformin plus acarbose),B(bedtime NPH insulin plus metformin),C(bedtime NPH insulin plus metformin plus diamicron).Period of treament were three months.FBG,PBG,Fc,Pc,CH,TG,LDL-TC,HDL-TC were detected before and after treatment,respectively.Results FBG,PBG,CH,TG,LDL-TC were significantly decreased and HDL-TC was significantly increased(P<0.05),however,Fc,Pc remained intact(P>0.05) in all groups.Fall degree of FBG in group C was larger than that in group A and group B.Fall degree of PBG in group A was the largest in all groups,and fall degree of PBG in group C was larger than that in group B.Conclusion Combination therapy with little dose of bedtime NPH insulin and oral antidiabetic agents was safe and effective in type 2 diabetes mellitus.It could improve insulin resistance.Metformin and diamicron associated with NPH insulin treatment was the first choice in FBG fall,metformin and acarbose in combination with NPH insulin was the best therapy in PBG fall.