目的 探究恩格列凈聯(lián)合吡格列酮治療2型糖尿病的臨床療效。方法 選取2018年6月-2019年5月于鄭州人民醫(yī)院接受治療的2型糖尿病患者98例，隨機(jī)分為對(duì)照組和治療組，每組各49例。對(duì)照組于每日早餐前口服鹽酸吡格列酮片，30 mg/次，1次/d。治療組在對(duì)照組治療基礎(chǔ)上口服恩格列凈片，10 mg/次，1次/d。兩組治療時(shí)間均為3個(gè)月。觀察兩組的臨床療效，比較兩組治療前后血糖相關(guān)指標(biāo)、氧化產(chǎn)物和抗氧化指標(biāo)的變化情況。結(jié)果 治療后，治療組總有效率是93.88%明顯高于對(duì)照組77.55%（P<0.05）。治療后，兩組空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）均出現(xiàn)顯著降低（P<0.05）；且治療組較對(duì)照組更低（P<0.05）；治療后，對(duì)照組體質(zhì)量指數(shù)（BMI）略高于治療前數(shù)值，差異無(wú)統(tǒng)計(jì)學(xué)意義；治療后治療組BMI顯著降低（P<0.05），且治療組治療后BMI顯著低于對(duì)照組（P<0.05）。治療后，兩組超氧化物歧化酶（SOD）、過(guò)氧化氫酶（CAT）、總抗氧化能力（T-AOC）均出現(xiàn)顯著升高，但丙二醛（MDA）、終末氧化蛋白產(chǎn)物（AOPP）均顯著降低（P<0.05）；治療后，治療組這些氧化產(chǎn)物和抗氧化指標(biāo)顯著優(yōu)于對(duì)照組（P<0.05）。治療后，治療組的不良反應(yīng)發(fā)生率是6.12%，顯著低于對(duì)照組的20.40%（P<0.05）。結(jié)論 恩格列凈聯(lián)合吡格列酮在2型糖尿病患者中的防治效果顯著，且可在一定程度上減少不良反應(yīng)，同時(shí)能夠明顯改善患者氧化-抗氧化平衡，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the efficacy of empagliflozin combined with pioglitazone in treatment of type 2 diabetes. Methods A total of 98 patients with type 2 diabetes treated in Zhengzhou People's Hospital from June 2018 to May 2019 were selected and randomly divided into control group and treatment group, with 49 patients in each group. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets, 30 mg/time, once daily. Patients in the treatment group were po administered with Empagliflozin Tablets on the basis of the control group, 10 mg/time, once daily. The duration of treatment in both groups was 3 months. The clinical efficacy of the two groups was observed, and the changes of blood glucose related indexes, oxidation products and antioxidant indexes before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 93.88%, significantly higher than that of the control group (77.55%, P<0.05). After treatment, fasting blood glucose (FPG), blood glucose (2 h PG) and glycosylated hemoglobin (HbA1c) were significantly decreased in both groups (P<0.05). The glycemic indexes in treatment group were lower than those in the control group (P<0.05). After treatment, the body mass index (BMI) of the control group was slightly higher than that before treatment, and the difference was not statistically significant. BMI of the treatment group was significantly reduced after treatment (P<0.05), and BMI of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (T-AOC) were significantly increased in both groups, but malondialdehyde (MDA) and terminal oxidizing protein product (AOPP) were significantly decreased in both groups (P<0.05). After treatment, the oxidation products and antioxidant indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the incidence of adverse reactions in the treatment group was 6.12%, significantly lower than that in the control group (20.40%, P<0.05). Conclusion Empagliflozin combined with pioglitazone has significant prevention and treatment effect in treatment of type 2 diabetes, and can reduce adverse reactions to a certain extent, and can significantly improve the patient's oxidation-antioxidant balance, which has certain clinical application value.

R977

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（2018020817）