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目的评价盐酸吡格列酮对2型糖尿病治疗的疗效和安全性。方法采用自身前后对照研究,纳入首次诊断为2型糖尿病且经饮食运动治疗三月以上或接受除噻唑烷二酮以外其它口服降糖药物治疗,剂量稳定三个月以上而血糖控制不满意的2型糖尿病患者84例,予盐酸吡格列酮30mg每日一次口服,疗程12周。已口服符合入选要求降糖药患者,联合并维持原有剂量的口服降糖药物治疗至随访结束。在试验开始和结束日,测量体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血红蛋白(Hb)、糖化血红蛋白(HbA1c),计算胰岛素抵抗指数(HOMA-IR)。对治疗前后上述指标进行对比分析。结果 81例患者完成完成全疗程治疗,平均病程(3.24±3.95)年;12周时FPG、HbA1c、FINS、HOMA-IR、SBP、DBP、TG、Hb均较治疗前基线时分别下降,HDL较治疗前基线时上升(1.11±0.29mmol/L比1.27±0.32 mmol/L,P<0.05);治疗期间不良反应少,大多未做特殊处理而自行好转。结论盐酸吡格列酮能改善胰岛素抵抗,有效降2型糖尿病患者的血糖水平,调节血脂,不良反应少,是一种安全有效的降糖药物。
Objective To evaluate the efficacy and safety of pioglitazone hydrochloride in the treatment of type 2 diabetes mellitus. Methods A self-control study was conducted. Patients with type 2 diabetes mellitus who were diagnosed for the first time and were treated with dietary exercise for more than three months or other oral hypoglycemic drugs other than thiazolidinedione were included in the study. The dose was stable for more than three months and the blood glucose control was not satisfactory 84 cases of type 2 diabetes, pioglitazone hydrochloride 30mg once daily oral treatment for 12 weeks. Oral hypoglycemic agents that have been enrolled in the study are eligible for oral administration, and the original dose of oral antidiabetic drugs is combined and maintained until the end of follow-up. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), fasting insulin (FINS), total cholesterol (TC) and triglyceride (TG) were measured at the beginning and the end of the experiment , HDL-C, LDL-C, Hb, HbA1c and HOMA-IR were calculated. Before and after treatment of the above indicators for comparative analysis. Results The complete course of treatment was completed in 81 patients, with a mean duration of (3.24 ± 3.95) years. The levels of FPG, HbA1c, FINS, HOMA-IR, SBP, DBP, TG and Hb decreased at 12 weeks Before treatment, the baseline increased (1.11 ± 0.29mmol / L vs 1.27 ± 0.32mmol / L, P <0.05). There were few adverse reactions during the treatment, and most of them improved without treatment. Conclusion Pioglitazone hydrochloride is a safe and effective antidiabetic drug which can improve insulin resistance, reduce blood glucose level, regulate blood fat level and less adverse reactions in type 2 diabetic patients.