二甲双胍联合比格列酮治疗肥胖新诊断2型糖尿病患者的疗效观察

目的:探讨二甲双胍与吡咯列酮联合治疗对肥胖的新诊断2型糖尿病患者的疗效。方法:选择2009年3月-2011年1月在内分泌科就诊的初诊肥胖的2型糖尿病患者128例,随机分为治疗组和对照组两组各64例。两组患者均予以饮食干预、运动疗法;对照组加用二甲双胍;观察组在对照组治疗基础上加用盐酸吡格列酮。两组患者均治疗3个月。结果:两组患者治疗前后FPG、2hPG、空腹C肽、餐后2hC肽、FINS、2hINS比较,均明显降低,组内治疗前后比较差异均有统计学意义(P<0.01,或P<0.05);治疗后,观察组FPG、2hPG、空腹C肽、餐后2hC肽、FINS、2hINS与对照组比较,降低更为明显,差异有统计学意义(P<0.05)。两组患者治疗前后BMI、HbAIc、hc-CRP比较,均明显改善,组内治疗前后比较差异均有统计学意义(P<0.01,或P<0.05);治疗后,观察组BMI、HbAIc、hc-CRP与对照组比较,改善更为明显,差异有统计学意义(P<0.05);两组血脂水平比较差异无统计学意义(P>0.05)。结论:二甲双胍联合吡格列酮治疗肥胖2型糖尿病时存在协同治疗效应,是治疗初诊2型糖尿病肥胖患者理想的方法。

Clinical Observation of the Combination of Metformin and Pioglitazone in Treating Obese Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Objective:To investigate the clinical effects of the treatment of combination of metformin and pioglitazone in first-visit obese patients with diagnosed type 2 diabetes mellitus.Methods:128 obese patients with newly diagnosed type 2 diabetes mellitus in our department from March 2009 to January 2011 were included and were randomly divided into the treatment group and the control group with 64 cases in each group.Dietary intervention and exercise therapy were given in both groups.While in the control group,metformin was given and in the treatment group,the combination of metformin and pioglitazone was given.The patients in the two groups were treated for 3 months.Results:FPG,2hPG,fasting C-peptide,two-hour postprandial C-peptide,FINS,and 2hINS were all significantly decreased after treatment in the two groups(P<0.01 or P<0.05);while FPG,2hPG,fasting C-peptide,two-hour postprandial C-peptide,FINS,and 2hINS in the treatment group were significantly decreased after treatment than that in the control group(P<0.05).BMI,HbAIc and hc-CRP were all significantly improved after treatment in the two groups(P<0.01 or P<0.05);while BMI,HbAIc and hc-CRP in the treatment group were much more significantly improved after treatment than that in the control group(P<0.05).However,there was no significant difference in blood lipid between the two groups(P>0.05).Conclusion:Combination of metformin and pioglitazone offered synergistic effects against type 2 diabetes mellitus in obese patients,and it was the ideal treatment for diagnosed type 2 diabetes mellitus in first-visit obese patients.