目的 探討卡格列凈聯(lián)合那格列奈治療2型糖尿病的臨床療效。方法 選取2022年4月—2023年6月聊城市第二人民醫(yī)院收治的96例2型糖尿病患者，依據(jù)用藥差異分為對照組（48例）和治療組（48例）。對照組餐前口服那格列奈片，120 mg/次，3次/d。在對照組的基礎(chǔ)上，治療組口服卡格列凈片，100 mg/次，1次/d；兩組患者連續(xù)用藥12周。觀察兩組患者的臨床療效，比較治療前后兩組患者血糖代謝指標(biāo)：空腹血糖（FBG）、餐后2 h血糖（PBG）、糖化血紅蛋白（HbA1c）和空腹胰島素（FINS），2型糖尿病患者生活質(zhì)量量表評分（DMQLS）、胰島素抵抗指數(shù)（HOMA-IR）及血清單核細(xì)胞趨化蛋白-1（MCP-1）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）和胰高血糖素樣肽-1（GLP-1）水平。結(jié)果 治療后，治療組總有效率為95.83%，明顯高于對照組的83.33%（P＜0.05）。治療后，兩組患者FBG、PBG、HbA1c、FINS、MCP-1、IL-6、TNF-α水平和HOMA-IR指數(shù)均明顯降低，而GLP-1水平和DMQLS評分明顯升高（P＜0.05），且治療后治療組這些指標(biāo)均明顯好于對照組（P＜0.05）。結(jié)論 卡格列凈與那格列奈協(xié)同治療時(shí)，能極大糾正升高的血糖，患者胰島素分泌得以改善，生活質(zhì)量提升明顯，機(jī)體炎性因子含量減弱。

Objective To explore the clinical effect of canagliflozin combined with nateglinide in treatment of type 2 diabetes. Methods Patients (96 cases) with type 2 diabetes in the Second People's Hospital of Liaocheng from April 2022 to June 2023 were divided into control (48 cases) and treatment (48 cases) group based on different treatments. Patients in the control group were po administered with Nateglinide Tablets, 120 mg/time, three times daily. Patients in the treatment group were po administered with Canagliflozin Tablets on the basis of the control group, 100 mg/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, the blood glucose metabolism indicators FBG, PBG, HbA1c and FINS, DMQLS scores and HOMA-IR indexes, and the levels of MCP-1, IL-6, TNF-α and GLP-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.83%, which was significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the levels of FBG, PBG, HbA1c, FINS, MCP-1, IL-6, TNF-α and HOMA-IR index were significantly decreased, while GLP-1 level and DMQLS score were significantly increased in two groups (P < 0.05), and the indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The combination of categlinide and nateglinide can greatly correct the elevated blood sugar, improve the insulin secretion, improve the quality of life and decrease the content of inflammatory factors.

R977

山東省科學(xué)技術(shù)成果評價(jià)項(xiàng)目（魯科成評字2022-187）