目的 探讨卡格列净联合吡格列酮治疗2型糖尿病的临床疗效。方法 选择2020年10月—2021年10月在巩义市人民医院治疗的84例糖尿病患者，随机分为对照组和治疗组，每组各42例。对照组口服盐酸吡格列酮片，15～30 mg/次，1次/d。在对照组的基础上，治疗组口服卡格列净片，100 g/次，1次/d。两组连续用药治疗6周。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，空腹血糖（FBG）、餐后2 h血糖（2 h PBG）、糖化血红蛋白（HbA1c）、白细胞介素-6（IL-6）、γ干扰素（INF-γ）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）水平。结果 治疗后，治疗组临床有效率为97.62%，显著高于对照组的78.57%（P＜0.05）。治疗后，治疗组患者多饮、消瘦、多尿、乏力等症状缓解时间均明显短于对照组（P＜0.05）。治疗后，两组FBG、2 h PBG、HbA1c、IL-6、INF-γ、TNF-α、CRP水平均明显下降（P＜0.05），且治疗组水平明显低于对照组（P＜0.05）。结论 卡格列净与吡格列酮联合治疗2型糖尿病，可明显控制患者血糖水平，改善炎症反应，有效缓解症状。

Objective To investigate the efficacy of canagliflozin combined with pioglitazone in treatment of type 2 diabetes. Methods Patients (84 cases) with type 2 diabetes in Gongyi City People’s Hospital from October 2020 to October 2021 were randomly divided into control and treatment group, and each group had 42 cases. Patients in the control group were po administered with Pioglitazone Hydrochlorid Tablets, 15 — 30 mg/time, once daily. Patients in the treatment group were po administered with Canagliflozin Tablets on the basis of the control group, 100 g/time, once daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of symptoms, the levels of FBG, 2 h PBG, HbA1c, IL-6, INF-γ, TNF-α and CRP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 97.62%, which was significantly higher than 78.57% in the control group (P < 0.05). After treatment, the remission time of symptoms such as excessive drinking, weight loss, polyuria and fatigue in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of FBG, 2 h PBG, HbA1c, IL-6, INF-γ, TNF-α and CRP in two groups were significantly decreased (P < 0.05), and the levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Canagliflozin combined with pioglitazone in treatment of type 2 diabetes can obviously control the blood glucose level, improve the inflammatory reaction and effectively relieve the symptoms.

R977

河南省医学科技攻关计划项目(2011020070)