目的 探討奧利司他膠囊聯(lián)合西格列汀二甲雙胍片治療肥胖型2型糖尿病的臨床療效。方法 選取2016年3月—2017年3月華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院收治的141例患者，隨機(jī)分為對照組（70例）和治療組（71例）。對照組患者口服西格列汀二甲雙胍片，1片/次，2次/d。治療組在對照組的治療基礎(chǔ)上口服奧利司他膠囊，1粒/次，3次/d。兩組患者均連續(xù)治療12周。觀察兩組患者的臨床療效，比較兩組患者治療前后空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）、總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、穩(wěn)態(tài)模型胰島素抵抗指數(shù)（HOMA-IR）和穩(wěn)態(tài)模型胰島β細(xì)胞功能指數(shù)（HOMA-β）的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為84.29%、95.77%。兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者的FPG、2 h PG、HbA1c、TC、TG、LDL-C、HOMA-IR、體質(zhì)量指數(shù)水平均較治療前顯著降低（P<0.05），HDL-C、HOMA-β水平升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組患者FPG、2 h PG、HbA1c、TC、TG、LDL-C、HOMA-IR、體質(zhì)量指數(shù)低于對照組，HDL-C、HOMA-β水平高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 奧利司他膠囊聯(lián)合西格列汀二甲雙胍片治療肥胖型2型糖尿病具有較好的臨床療效，可顯著改善患者血糖水平，安全性較高，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the efficacy of Orlistat Capsules combined with Sitagliptin Phosphate/metformin Hydrochloride Tablets in treatment of obesity type 2 diabetes. Methods Patients (141 cases) with obesity type 2 diabetes in Tongji Medical College Affiliated Union Hospital of Huazhong University of Science and Technology from March 2016 to March 2017 were randomly divided into control (70 cases) and treatment (71 cases) groups. Patients in the control group were po administered with Sitagliptin Phosphate/metformin Hydrochloride Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Orlistat Capsules on the basis of the control group, 1 grain/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HDL-C, HOMA-IR, and HOMA-β in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group were 84.29% and 95.77%, and there were differences between two groups (P < 0.05). After treatment, FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HOMA-IR, and body mass index in two groups were significantly decreased, but HDL-C, HOMA-β were significantly increased, and there were differences in the same group (P < 0.05). After treatment, FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HOMA-IR, and body mass index in the treatment group were lower than those in the control group, but HDL-C, HOMA-β in the treatment group were higher than those in the control group, and there were differences between two groups (P < 0.05). Conclusion Orlistat Capsules combined with Sitagliptin Phosphate/metformin Hydrochloride Tablets has significant clinical effect in treatment of obesity type 2 diabetes, and can significantly improve the blood glucose level with high safety, which has a certain clinical application value.