目的 分析2018年广州医科大学附属第二医院糖尿病患者降糖药物的使用情况，为降糖药的临床合理应用提供科学依据。方法 抽取广州医科大学附属第二医院2018年1~12月住院的糖尿病患者共821例，综合分析患者的基本情况、糖尿病分型及病程、口服降糖药与胰岛素的使用情况，并对其使用合理性进行分析。结果 男性患者多于女性患者，60~79岁老年患者最多。2型糖尿病患者人数最多，共800例，占97.44%。病程10年以上的患者有428例，占52.13%。单纯使用胰岛素治疗的有123例，单纯用一种口服降糖药的有202例。两种降糖药联合使用方案以二甲双胍+α-糖苷酶抑制剂的联合模式最多，三联用药方案常用方案有二甲双胍+α-糖苷酶抑制剂+磺脲类，四药联合的情况不多。821例中有104例不合理医嘱，占医嘱总数的12.67%，主要表现在重复用药、联合用药不合理、药物品种选择不合理与用法用量不合理，尤其是胰岛素促泌剂的重复用药以及胰岛素的联合用药问题较为突出。结论 广州医科大学附属第二医院糖尿病的药物治疗总体遵循治疗原则，但仍存在胰岛素、磺脲类药物使用不当的问题，急需对非内分泌专科医生进行合理用药指导。

Objective To analyze the utilization of hypoglycemic drugs in diabetic patients of the Second Affiliated Hospital of Guangzhou Medical University in 2018, and provide scientific evidence for clinical rational use of hypoglycemic drugs. Methods 821 Diabetic patients were selected in the Second Affiliated Hospital of Guangzhou Medical University from January to December 2018. The patients' basic situation, classification and course of diabetes, usage of oral antidiabetics and insulin, and rationality of medication were comprehensively analyzed. Results The male was more than female, and the age of most patients was 60-79 years old. Most of patients were with type 2 diabetes (800 cases, 97.44%). Patients with the course above 10 years were 428 cases, accounting for 52.13%.There was 123 cases of patients using insulin alone and 202 cases of patients using oral hypoglycemic drugs alone. The combination mode of metformin + α-glucosidase inhibitor was the most common combination of two antidiabetic drugs. Metformin + α-glucosidase inhibitor + sulfonylureas was the most common combination of three antidiabetic drugs. The combination of four drugs was rare. There were 104 unreasonable treatment orders in 821 cases, accounting for 12.67% of total orders. The irrational orders mainly include repeated medication, unreasonable combined medication, inappropriate drug selection, inappropriate dosage or usage, especially repeated use of insulin secretagogues and combined use of insulin. Conclusion The pharmacotherapy of diabetes mellitus in the Second Affiliated Hospital of Guangzhou Medical University generally conforms to the principle of treatment, but there still exist some problems in improper use of insulin and sulfonylureas, calling for effective guidance to reasonable use of antidiabetics for non-endocrinologist.

广东省医学科研基金资助项目（A2018370）；广东省医院药学研究基金资助项目（2018A12）；广州市卫计委西医一般引导项目（20191A011085）