Abstract:

Objective　To explore the efficacy and safety of nicorandil combined with metformin in the treatment of type 2 diabetes mellitus complicated with coronary heart disease. Methods　It was a randomized controlled trial. A total of 92 patients with type 2 diabetes mellitus complicated with coronary heart disease admitted to Internal Medicine, Jinan Minzu Hospital from June 2021 to January 2022 were selected as the research objects. They were divided into a combined group and a conventional group by the random number table method, with 46 cases in each group. In the conventional group, there were 26 females and 30 males, aged 50-80 years, with an age of (69.41±8.02) years old. In the combined group, there were 25 females and 31 males, aged 56-79 years, with an age of (68.74±7.79) years old. The conventional group was treated with metformin tablets, and the combined group was treated with metformin tablets plus nicorandil. After 2 months of treatment, the blood glucose indexes, cardiac function indexes [left ventricular end-diastolic volume index (LVD-VI) and left ventricular ejection fraction (LVEF)], and efficacies of the two groups were evaluated, and the incidence of adverse drug reactions was recorded. t test, χ² test, and rank sum test were used. Results　After treatment, the 2 h postprandial blood glucose and fasting blood glucose in the combined group were lower than those in the conventional group [(8.14±0.61) mmol/L vs. (9.89±1.04) mmol/L, (6.10±0.78) mmol/L vs. (6.89±0.90) mmol/L] (t=4.499, P<0.001; t=9.844, P<0.001). The LVEF after treatment was higher than that before treatment in both groups, and the LVEF in the combined group was higher than that in the conventional group [(48.37±6.02) % vs. (44.12±5.81) %] (t=2.205, P=0.030). The LVED-VI after treatment was lower than that before treatment in both groups, and the LVED-VI in the combined group was lower than that in the conventional group [(63.42±9.13) vs. (67.29±8.93)] (t=3.696, P<0.001). The rank sum test showed that the efficacy of the combined group was better than that of the conventional group, with a statistically significant difference (Z=2.049, P=0.040). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.449, P=0.503). Conclusion　Nicorandil combined with metformin in the treatment of type 2 diabetes mellitus complicated with coronary heart disease has superior hypoglycemic effect, and improves the cardiac function, with good safety.

Key words:

Nicorandil, Metformin, Type 2 diabetes mellitus, Coronary heart disease, Security

摘要：

目的　探究尼可地尔联合二甲双胍治疗2型糖尿病合并冠心病患者的疗效和安全性。方法　本研究为随机对照试验。选取济南市民族医院内科2021年6月至2022年1月收治的92例2型糖尿病合并冠心病患者作为研究对象，采用随机数字表法分为联合组和常规组，均46例。常规组女26例，男30例，年龄50～80（69.41±8.02）岁；联合组女25例，男31例，年龄56～79（68.74±7.79）岁。常规组口服二甲双胍片治疗，联合组口服二甲双胍片+尼可地尔治疗。治疗2个月后评估两组血糖指标、心功能指标［左心室舒张末期容积指数（LVED-VI）、左心室射血分数（LVEF）］、疗效，记录药物不良反应发生率。采用t检验、χ²检验、秩和检验。结果　治疗后，联合组餐后2 h血糖、空腹血糖低于常规组［（8.14±0.61）mmol/L比（9.89±1.04）mmol/L，（6.10±0.78）mmol/L比（6.89±0.90）mmol/L］（t=4.499，P<0.001；t=9.844，P<0.001）。两组治疗后LVEF均高于治疗前，且联合组LVEF高于常规组［（48.37±6.02）%比（44.12±5.81）%］（t=2.205，P=0.030）；两组治疗后LVED-VI均低于治疗前，且联合组LVED-VI低于常规组［（63.42±9.13）比（67.29±8.93）］（t=3.696，P<0.001）。经秩和检验，联合组疗效优于常规组，差异有统计学意义（Z=2.049，P=0.040）。两组不良反应发生率比较差异无统计学意义（χ²=0.449，P=0.503）。结论　尼可地尔联合二甲双胍治疗2型糖尿病合并冠心病患者效果优越，改善患者的心功能，且安全性良好。

关键词:

尼可地尔, 二甲双胍, 2型糖尿病, 冠心病, 安全性