目的 探討恩格列凈聯(lián)合利格列汀治療2型糖尿病的臨床療效。方法 選取2018年6月-2019年8月武漢亞心總醫(yī)院收治的120例2型糖尿病患者作為研究對(duì)象。將患者隨機(jī)分為對(duì)照組和觀察組，每組各60例。對(duì)照組患者口服利格列汀片，5 mg/次，1次/d；觀察組在對(duì)照組的基礎(chǔ)上口服恩格列凈片，10 mg/次，1次/d。所有患者均經(jīng)24周連續(xù)服藥治療。觀察兩組的臨床療效，比較兩組患者治療前后的體質(zhì)量指數(shù)（BMI）、空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）、空腹胰島素（FINS）、餐后2 h胰島素（2 h INS）、腫瘤壞死因子（TNF-α）、白細(xì)胞介素-4（IL-4）、白細(xì)胞介素-6（IL-6）、谷胱甘肽過(guò)氧化物酶（GSH-px）、超氧化物歧化酶（SOD）、丙二醛（MDA）水平。結(jié)果 治療后，對(duì)照組和觀察組總有效率分別為86.67%和95.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組患者BMI值比治療前顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組BMI值顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的FBG、2 h PG、HbA1c水平均較治療前顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組FBG、2 h PG和HbA1c水平均顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的血清FINS和餐后2 h INS水平均較治療前顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組的FINS和2 h INS均顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者IL-4、IL-6和TNF-α水平均較治療前顯著下降，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組的IL-4、IL-6和TNF-α與對(duì)照組相比顯著降低，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組GSH-px和SOD水平均升高，MDA水平均下降，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組GSH-px和SOD水平明顯高于對(duì)照組，MDA水平顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 恩格列凈聯(lián)合利格列汀治療2型糖尿病，可顯著降低血糖，改善患者胰島素抵抗，并顯著改善患者的炎癥反應(yīng)和氧化應(yīng)激水平，且安全性良好。

Objective To investigate the clinical effect of empagliflozin combined with linagliptin in treatment of type 2 diabetes. Methods Patients (120 cases) with type 2 diabetes in Wuhan Asia General Hospital from June 2018 to August 2019 were randomly divided into control group and observation group, each group had 60 cases. Patients in control group were po administered with Linagliptin Tablets, 5mg/time, once daily. Patients in observation group were po administered with Empagliflozin Tablets on the basis of control group, 10 mg/time, once daily. Patients in two groups were treated for 24 weeks. The clinical effects in two groups were observed, and the BMI, FBG, 2 h PG, HbA1c, FINS, 2 h INS, TNF-α, IL-4, IL-6, GSH-px, SOD, and MDA levels before and after treatment were compared. Results After treatment, the total effective rate in the control group and observation group was 86.67% and 95.00%, respectively, the difference between two groups was statistically significant (P<0.05). After treatment, the BMI value in the observation group was significantly lower than that before treatment, and the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the BMI value in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, FBG, 2 h PG and HbA1c levels in two groups were significantly lower than thnose before treatment, and the differences before and after treatment in the same group were statistically significant (P<0.05). After treatment, FBG, 2 h PG and HbA1c levels in the observation group were significantly lower than those in the control group, and the differences between the two groups were statistically significant (P<0.05). After treatment, the serum FINS and 2 h post-meal INS levels in two groups were significantly lower than those before treatment, and the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the FINS and 2 h INS in the observation group were significantly lower than those in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the levels of IL-4, IL-6 and TNF-α in two groups were significantly lower than those before treatment, and the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, IL-4, IL-6 and TNF-α levels in the observation group were significantly decreased compared with the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of GSH-px and SOD in two groups were increased, and the levels of MDA was decreased, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the levels of GSH-px and SOD in the observation group was significantly higher than those in the control group, but the level of MDA was significantly lower than that in the control group, and the difference between two groups was statistically significant (P<0.05). Conclusion Empagliflozin combined with linagliptin in treatment of type 2 diabetes mellitus can significantly reduce blood glucose, improve the insulin resistance, and significantly improve inflammatory response and oxidative stress levels in patients with good safety.

R977

中央高校基本科研業(yè)務(wù)費(fèi)專項(xiàng)資金（2017KFYXJJ252）