目的 探究司美格魯肽聯(lián)合恩格列凈治療肥胖2型糖尿病的臨床效果。方法 選取2022年9月—2023年12月在西安交通大學(xué)第二附屬醫(yī)院治療的肥胖2型糖尿病患者199例，根據(jù)治療方案差異分成對照組（99例）和治療組（100例）。對照組患者口服恩格列凈片，10 mg/次，1次/d。治療組患者在對照組基礎(chǔ)上皮下注射司美格魯肽注射液，1次/周，前4周0.25 mg/周，5～8周0.5 mg/周，9周開始劑量1 mg/周。兩組患者均進行12周治療。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀負擔評估量表（DSC-R）和糖尿病生存質(zhì)量特異性量表（DSQL）評分，血糖指標糖化血紅蛋白（HbA1c）、空腹血糖（FBG）和餐后2 h血糖（2 h PG）水平，及血脂指標總膽固醇（TC）、三酰甘油（TG）和高密度脂蛋白膽固醇（HDL-C）水平。結(jié)果 治療后，對照組和治療組的總有效率分別為85.86%和97.00%，兩組比較差異具有統(tǒng)計學(xué)意義（P＜0.05）。治療后，治療組患者DSC-R評分和DSQL評分明顯下降（P＜0.05），且治療組評分明顯優(yōu)于對照組（P＜0.05）。治療后，兩組患者血糖指標HbA1c、FBG、2 h PG水平均較治療前顯著下降（P＜0.05），且治療組血糖指標明顯優(yōu)于對照組（P＜0.05）。治療后，兩組血脂指標TC、TG水平較治療前顯著下降，而HDL-C顯著升高（P＜0.05），且治療組患者血脂指標顯著優(yōu)于對照組（P＜0.05）。結(jié)論 司美格魯肽聯(lián)合恩格列凈治療肥胖2型糖尿病治療效果顯著，不僅能夠顯著改善患者癥狀負擔水平和生存質(zhì)量，同時還能夠促進糖脂代謝指標的恢復(fù)。

Objective To explore the therapeutic effect of semaglutide combined with empagliflozin in treatment of obese type 2 diabetes.Methods Patients (199 cases) with obese type 2 diabetes in the Second Affiliated Hospital of Xi’an Jiaotong University from September 2022 to December 2023 were divided into control (99 cases) and treatment (100 cases) group based on different treatments. Patients in the control group were po administered with Empagliflozin Tablets, 10 mg/time, once daily. Patients in the treatment group were sub-cutaneous administered with Semaglutide Injection, 0.25 mg/week for the first 4 weeks, 0.5 mg/week for 5 — 8 weeks, and 1 mg/week from week 9, once weekly. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, the scores of DSC-R and DSQL, the levels of blood glucose indexes HbA1c, FBG and 2 h PG, and the levels of blood lipid indexes TC, TG and HDL-C in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 85.86% and 97.00%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the DSC-R and DSQL scores in the treatment group were significantly decreased (P < 0.05), and the score of the treatment group was significantly better than that of the control group (P < 0.05). After treatment, the blood glucose indicators HbA1c, FBG, and 2 h PG levels in two groups were significantly decreased compared with those before treatment (P < 0.05), and the blood glucose indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of blood lipids TC and TG in two groups were significantly decreased compared with those before treatment, while HDL-C was significantly increased (P < 0.05), and the blood lipids in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Smeglutide combined with empagliflozin has a significant therapeutic effect in the treatment of obese type 2 diabetes, which can not only significantly improve the burden of symptoms and quality of life of patients, but also promote the recovery of glucose and lipid metabolism indicators.

R977

陜西省重點研發(fā)計劃項目（2022SF-140）