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目的观察甘精胰岛素注射液联合阿卡波糖片治疗磺脲类继发性失效的2型糖尿病患者的临床疗效。方法 80例磺脲类继发性失效的2型糖尿病患者均皮下注射甘精胰岛素注射液,每次10单位,每天1次;口服阿卡波糖片,每次50 mg,每天3次。治疗期间根据患者血糖变化对甘精胰岛素及阿卡波糖用量进行调整,疗程为3个月。观察治疗前后患者的临床疗效、血糖控制情况及药物不良反应发生情况。结果治疗后,临床总有效率为90.00%(72/80例)。治疗前,患者空腹血糖、餐后血糖、糖化血红蛋白(Hb A1c)含量分别为(9.34±2.04)mmol·L~(-1),(12.15±3.61)mmol·L~(-1),(8.82±2.53)%,治疗后,患者空腹血糖、餐后血糖、糖化血红蛋白含量分别为(6.23±1.26)mmol·L~(-1),(8.35±2.18)mmol·L~(-1),(6.64±1.23)%,差异有统计学意义(P<0.05)。治疗过程中,头晕、心慌、出冷汗、视物模糊等药物不良反应发生率为8.75%(7/80例),对症治疗后消失。结论甘精胰岛素注射液联合阿卡波糖片治疗继发性失效的2型糖尿病患者,有效控制血糖水平,药物不良反应发生率低。
Objective To observe the clinical efficacy of insulin glargine injection combined with acarbose in the treatment of type 2 diabetes mellitus secondary to sulfonylurea failure. Methods Eighty patients with type 2 diabetes mellitus secondary to sulfonylurea were injected subcutaneously with glargine at a dose of 10 units once daily. Acarbose orally taken 50 mg once daily for 3 times. During treatment based on changes in blood glucose in patients with insulin glargine and acarbose dosage adjustments, treatment for 3 months. Observed before and after treatment in patients with clinical efficacy, glycemic control and adverse drug reactions. Results After treatment, the total clinical effective rate was 90.00% (72/80 cases). The levels of fasting blood glucose, postprandial blood glucose and Hb A1c in patients before treatment were 9.34 ± 2.04 mmol·L -1, 12.15 ± 3.61 mmol·L -1 and 8.82% ± 2.53)%. After treatment, the levels of fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin were (6.23 ± 1.26) mmol·L -1, (8.35 ± 2.18) mmol·L -1, 6.64 ± 1.23)%, the difference was statistically significant (P <0.05). During treatment, dizziness, palpitation, cold sweat, blurred vision and other adverse drug reactions occurred in 8.75% (7/80 cases), disappeared after symptomatic treatment. Conclusion Glargine injection combined with acarbose in the treatment of secondary failure of type 2 diabetes, effective control of blood glucose levels, the incidence of adverse drug reactions is low.