目的 分析二甲雙胍聯(lián)合西格列汀對(duì)初診2型糖尿?。═2DM）患者臨床治療效果。方法 選取2014年11月-2016年12月在河南科技大學(xué)第一附屬醫(yī)院接受治療T2DM患者128例，采用隨機(jī)法分為對(duì)照組（n=60）和聯(lián)合組（n=68）。對(duì)照組患者在常規(guī)低糖飲食和運(yùn)動(dòng)輔助治療下給予二甲雙胍治療，聯(lián)合組患者在對(duì)照組基礎(chǔ)上加用西格列汀治療。兩組療程均為6個(gè)月。觀察并比較兩組患者療效、血糖、血脂、炎癥因子、肝功水平及不良反應(yīng)情況。結(jié)果 聯(lián)合組患者治療后總有效率為92.65%，顯著高于對(duì)照組的71.67%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者治療前體質(zhì)指數(shù)（BMI）、空腹血糖（FPG）、餐后2 h血糖（2hPG）、血漿C肽（FCP）、糖化血紅蛋白（HbA1c）比較無統(tǒng)計(jì)學(xué)差異；兩組患者治療后BMI、FPG、2hPG水平及HbA1c均較治療前下降，且聯(lián)合組患者BMI、FPG、2hPG水平及HbA1c低于對(duì)照組患者，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者治療前腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-8（IL-8）水平比較無統(tǒng)計(jì)學(xué)差異；聯(lián)合組患者治療后TNF-α、IL-6及IL-8水平均低于治療前和對(duì)照組治療后患者，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；對(duì)照組患者治療前后TNF-α、IL-6及IL-8水平比較無統(tǒng)計(jì)學(xué)差異。兩組患者治療前后膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、尿素氮（BUN）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、天門冬氨酸氨基轉(zhuǎn)移酶（AST）及血肌酐（Scr）水平比較，差異無統(tǒng)計(jì)學(xué)意義。聯(lián)合組患者消化系統(tǒng)不良反應(yīng)率低于對(duì)照組患者，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 二甲雙胍聯(lián)合西格列汀治療初診2型糖尿病療效顯著，可控制血糖和炎癥因子水平，且不影響肝功能水平，不良反應(yīng)小，安全性高。

Objective To analyze the clinical effect of metformin combined with western medicine in the treatment of newly diagnosed type 2 diabetes mellitus (T2DM). Methods 128 patients with T2DM who were treated in our hospital from November 2014 to December 2016 were randomly divided into control group (n=60) and combination group (n=68).The patients in the control group were given metformin treatment with conventional low sugar diet and exercise therapy, and the patients in the combined group were treated with Sig Leo Dean on the basis of the control group. The two groups were observed and compared the curative effect, blood glucose, blood lipid, inflammatory factors, liver function and adverse reactions. Results The patients treated with the combined group were treated with 49 cases, 14 of which were effective, and the total effective rate was 92.65% higher than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in BMI, FPG, 2hPG, FCP and HbA1c before treatment between the two groups. After treatment, BMI, FPG, 2hPG and HbA1c were decreased in all two groups, and the levels of BMI, FPG, 2hPG and HbA1c in the combined group were lower than those in the control group (P<0.05). There was no significant difference in the levels of TNF-α, IL-6 and IL-8 before treatment between the two groups. After treatment, TNF-α, IL-6 and IL-8 in the combined group were lower than those before treatment and control group (P<0.05). The levels of TNF-α, IL-6 and IL-8 were not significantly different between the control group and the control group. Two groups of patients before and after treatment TC, LDL-C, HDL-C, ALT, AST, BUN and Scr levels, the difference was not statistically significant.
The adverse reaction rate of digestive system in the combined group was lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion Metformin combined with western medicine in the treatment of newly diagnosed type 2 diabetes has a significant effect, can control the level of blood glucose and inflammatory factors, and does not affect the level of liver function, adverse reactions, high safety.