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达格列净联合黄连素治疗脆性2型糖尿病的临床观察
周洁      吴新华      马立明      严妍      时雯      李行      朱平
江苏省淮安市肿瘤医院内分泌科,江苏淮安   223200
Clinical observation of Dapagliflozin combined with Berberine in the treatment of fragile type 2 diabetess
ZHOU Jie   WU Xinhua   MA Liming   YAN Yan   SHI Wen   LI Hang   ZHU Ping
Department of Endocrinology, Huai’an Cancer Hospital, Jiangsu Province, Huaian   223200, China
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摘要 目的 观察达格列净联合黄连素治疗脆性2型糖尿病的临床效果。 方法 选取江苏省淮安市肿瘤医院2018年4月—2020年3月收治的60例脆性2型糖尿病患者,抛硬币法随机分为观察组(30例)和对照组(30例)。对照组给予单纯胰岛素强化治疗方案,观察组达格列净+黄连素治疗。比较两组治疗前后脂代谢及体重指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、体重(BW)、体重指数(BMI)],比较治疗前后血糖及胰岛素控制指标变化[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、C肽(CP)]、血糖波动情况[餐后血糖波动幅度(PPGE)、日间血糖平均绝对差(MODD)、血糖水平标准差(SDBG)]、血压及胰岛素日使用量[收缩压(SBP)、舒张压(DBP)、胰岛素日使用量],比较两组不良反应发生情况。 结果 治疗后两组TG、TC、LDL-C、BW、BMI水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。治疗后两组HbA1c、FPG、2hPG水平较治疗前降低,FINS、CP较治疗前升高,且观察组HbA1c、FPG、2hPG水平低于对照组,FINS、CP高于对照组,差异有统计学意义(P < 0.05)。治疗后两组PPGE、MODD、SDBG较治疗前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。治疗后两组SAP、DAP、胰岛素日使用量水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。两组不良反应总发生率比较,差异无统计学意义(P > 0.05)。 结论 达格列净联合黄连素治疗脆性2型糖尿病患者效果显著,可改善血糖水平,用药安全性高。
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周洁 吴新华 马立明 严妍 时雯 李行 朱平
关键词 达格列净黄连素脆性2型糖尿病血糖    
Abstract:Objective To observe the clinical effect of Dapagliflozin combined with Berberine in the treatment of fragile type 2 diabetes. Methods A selection of 60 patients with fragile type 2 diabetes who were admitted to Huai’an Cancer Hospital in Jiangsu Province from April 2018 to March 2020 were randomly divided into observation group (30 cases) and control group (30 cases) by coin flipping. The control group was given intensive insulin therapy alone, and the observation group was treated with Dapagliflozin + Berberine. The lipid metabolism and body mass index (triacylglycerol [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], body weight [BW], body mass indexes [BMI]) before and after treatment between the two groups were compared, and treatments changes in blood glucose and insulin control indicators (glycated hemoglobin [HbA1c], fasting plasma glucose [FPG], 2 h postprandial blood glucose [2hPG], fasting insulin [FINS], C peptide [CP]), blood glucose fluctuations (postprandial blood glucose fluctuation amplitude [PPGE], mean absolute difference of blood sugar [MODD], standard deviation of blood sugar level [SDBG]), blood pressure and daily use of insulin [systolic blood pressure (SBP), diastolic blood pressure (DBP), daily use of insulin] were compared before and after treatment. The occurrence of adverse reactions between the two groups was compared. Results After treatment, the levels of TG, TC, LDL-C, BW, and BMI in the two groups were lower than before treatment, while the observation group were lower than the control group, and the differences were statistically significant (P < 0.05). After treatment, the levels of HbA1c, FPG, and 2hPG in the two groups were lower than before treatment, while FINS and CP were higher than before treatment, and the levels of HbA1c, FPG, and 2hPG in the observation group were lower than those in the control group, while FINS and CP were higher than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, PPGE, MODD, and SDBG in the two groups were lower than before treatment, while the observation group were lower than the control group, and the differences were statistically significant (P < 0.05). After treatment, the daily consumption levels of SAP, DAP, and daily use of insulin in the two groups were lower than before treatment, while the observation group were lower than the control group, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion Dapagliflozin combined with Berberine has a significant effect in the treatment of patients with fragile type 2 diabetes, which can improve blood sugar levels and has high drug safety.
Key wordsDapagliflozin    Berberine    Fragile type 2 diabetes    Blood glucose
    
基金资助:江苏省淮安市卫生健康科研面上项目(HAWJ 201927)。
通讯作者: 朱平(1984.8-),女,博士,副主任医师;研究方向:内分泌疾病。   
作者简介: 周洁(1989.3-),女,硕士;研究方向:内分泌疾病方向研究。
引用本文:   
周洁 吴新华 马立明 严妍 时雯 李行 朱平. 达格列净联合黄连素治疗脆性2型糖尿病的临床观察[J]. 中国医药导报, 2021, 18(15): 75-78,83.
ZHOU Jie WU Xinhua MA Liming YAN Yan SHI Wen LI Hang ZHU Ping. Clinical observation of Dapagliflozin combined with Berberine in the treatment of fragile type 2 diabetess. 中国医药导报, 2021, 18(15): 75-78,83.
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https://www.yiyaodaobao.com.cn/CN/     或     https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I15/75

 

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