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目的观察胰岛素增敏剂马来酸罗格列酮(文迪雅)联合盐酸二甲双胍治疗初发性2型糖尿病的疗效和安全性。方法选择初发2型糖尿病患者26例,根据血糖情况分为两组,一组空腹血糖为7.8~13 mmol/L(15例),本组患者给以马来酸罗格列酮4 mg/d,盐酸二甲双胍片0.5 g/次,3次/d,口服。一组空腹血糖为大于13 mmol/L(11例),查尿酮体阴性,本组患者给以重组人胰岛素(诺和灵30R)和盐酸二甲双胍片0.5 g次/,3次/d,口服。两组患者均控制饮食及运动锻炼,观察用药前后血糖、血脂、糖化血红蛋白、体重指数、胰岛素、C肽等。结果两组患者在治疗12周后血糖、糖化血红蛋白、胰岛素、C肽均有明显下降,差异具有统计学意义(P<0.05),两组疗效相似。罗格列酮主要副作用为双下肢水肿,无明显肝肾功能损害。胰岛素组主要副作用为低血糖。两组中个别患者出现糖尿病蜜月期。结论马来酸罗格列酮联合盐酸二甲双胍可作为初发性2型糖尿病的一线用药,具有良好的疗效和安全性。
Objective To observe the efficacy and safety of insulin sensitizer rosiglitazone maleate (Avandia) combined with metformin hydrochloride in the treatment of idiopathic type 2 diabetes mellitus. Methods Twenty-six patients with newly diagnosed type 2 diabetes were divided into two groups according to their blood glucose. One group had fasting blood glucose of 7.8-13 mmol / L (15 cases). The patients were given rosiglitazone 4 mg / d, metformin hydrochloride tablets 0.5 g / time, 3 times / d, orally. A group of fasting blood glucose greater than 13 mmol / L (11 cases), check urine ketone body negative, the patients given recombinant human insulin (Novolin 30R) and metformin hydrochloride tablets 0.5 g times /, 3 times / d, orally. Both groups controlled diet and exercise, and observed blood glucose, blood lipid, glycosylated hemoglobin, body mass index, insulin and C-peptide before and after treatment. Results The blood glucose, glycosylated hemoglobin, insulin and C-peptide in both groups decreased significantly after 12 weeks treatment, with statistical significance (P <0.05). The curative effect was similar between the two groups. Rosiglitazone main side effects of edema of both lower extremities, no significant liver and kidney dysfunction. The main side effect of the insulin group is hypoglycemia. Individuals in both groups had diabetic honeymoon. Conclusion Rosiglitazone maleate combined with metformin hydrochloride can be used as a first-line medication for type 2 diabetes mellitus, with good efficacy and safety.