Abstract:

Objective　To investigate the efficacy of chiglitazar sodium combined with recombinant human insulin in the treatment of type 2 diabetes mellitus (T2DM). Methods　A prospective study was carried out on 90 patients with T2DM who were treated in Tongchuan People's Hospital from February 2022 to February 2024. The patients were divided into two groups according to the random number table method. In the control group, there were 26 males and 19 females, aged (65.46±3.53) years, and the course of disease was (7.78±1.24) years. In the observation group, there were 27 males and 18 females, aged (66.13±3.42) years, and the course of disease was (8.14±1.37) years. The control group was treated with recombinant human insulin (recombinant human insulin injection 0.4-0.6 U/kg, subcutaneous injection into the abdomen 30 min before breakfast and dinner, twice a day). The observation group was combined with chiglitazar sodium on the basis of the control group (oral chiglitazar sodium tablets, 2 tablets/time, once a day). Both groups were treated for 3 months. The levels of blood glucose, fasting insulin, blood lipid indexes, and inflammatory factors before and after treatment, adverse reactions, and clinical efficacy of both groups were observed. t test and χ² test were used for statistical analysis. Results　After treatment, the levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycated hemoglobin (HbA1c), fasting insulin, total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) in the observation group were lower than those in the control group [(6.63±1.28) mmol/L vs. (7.95±1.56) mmol/L, (8.24±1.23) mmol/L vs. (10.16±1.65) mmol/L, (6.49±0.54) % vs. (7.36±0.87) %, (10.69±1.72) mU/L vs. (16.33±1.43) mU/L, (4.12±0.18) mmol/L vs. (4.95±0.63) mmol/L, (1.23±0.24) mmol/L vs. (1.76±0.38) mmol/L, (3.04±0.23) mmol/L vs. (3.86±0.75) mmol/L], while the level of high density lipoprotein cholesterol (HDL-C) was higher than that in the control group [(1.68±0.16) mmol/L vs. (1.23±0.19) mmol/L], with statistically significant differences (t=4.388, 6.258, 5.699, 16.914, 8.497, 7.910, 7.011, and 12.152, all P<0.05). The levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in the observation group were lower than those in the control group, with statistically significant differences (t=6.489, 4.124, and 14.999, all P<0.05). The total effective rate of the observation group was higher than that of the control group [95.55% (43/45) vs. 77.77% (35/45)], the difference was statistically significant (χ²=6.153, P<0.05). Conclusion　In T2DM patients, chiglitazar sodium combined with recombinant human insulin can reduce the blood glucose level, improve the level of blood lipids, reduce the inflammatory reaction, and improve the clinical efficacy.

Key words:

Type 2 diabetes mellitus, Chiglitazar sodium, Recombinant human insulin, Blood glucose, Efficacy

摘要：

目的　探讨2型糖尿病（T2DM）患者应用西格列他钠联合重组人胰岛素的治疗效果。方法　采用前瞻性研究，选取2022年2月至2024年2月在铜川市人民医院接受治疗的90例T2DM患者作为研究对象，按随机数字表法分为两组，各45例。对照组：男26例，女19例，年龄（65.46±3.53）岁，病程（7.78±1.24）年；给予重组人胰岛素治疗（重组人胰岛素注射液0.4～0.6 U/kg，2次/d，于早、晚餐前30 min腹部皮下注射）。观察组：男27例，女18例，年龄（66.13±3.42）岁，病程（8.14±1.37）年；在对照组的基础上联合西格列他钠治疗（西格列他钠片口服，2片/次，1次/d）。两组均治疗3个月。观察两组治疗前后血糖水平、空腹胰岛素、血脂指标、炎症因子、不良反应及临床疗效。采用t检验、χ²检验进行统计分析。结果　治疗后，观察组空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、空腹胰岛素、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均低于对照组［（6.63±1.28）mmol/L比（7.95±1.56）mmol/L、（8.24±1.23）mmol/L比（10.16±1.65）mmol/L、（6.49±0.54）%比（7.36±0.87）%、（10.69±1.72）mU/L比（16.33±1.43）mU/L、（4.12±0.18）mmol/L比（4.95±0.63）mmol/L、（1.23±0.24）mmol/L比（1.76±0.38）mmol/L、（3.04±0.23）mmol/L比（3.86±0.75）mmol/L］，高密度脂蛋白胆固醇（HDL-C）水平高于对照组［（1.68±0.16）mmol/L比（1.23±0.19）mmol/L］，差异均有统计学意义（t=4.388、6.258、5.699、16.914、8.497、7.910、7.011、12.152，均P<0.05）。观察组C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平均低于对照组，差异均有统计学意义（t=6.489、4.124、14.999，均P<0.05）。观察组临床总有效率高于对照组［95.55%（43/45）比77.77%（35/45）］，差异有统计学意义（χ²=6.153，均P<0.05）。结论　T2DM患者应用西格列他钠联合重组人胰岛素治疗，可降低血糖水平，改善血脂水平，减轻炎症反应，提高临床疗效。

关键词:

2型糖尿病, 西格列他钠, 重组人胰岛素, 血糖, 疗效