目的 探讨格列美脲联合沙格列汀治疗2型糖尿病的临床效果和安全性。方法 选取上海市徐汇区中心医院2016年11月-2017年11月收治的2型糖尿病患者64例，随机分成对照组和治疗组，每组各32例。对照组早餐前0.5 h口服沙格列汀片，5 mg/次，1次/d。治疗组在对照组基础上早餐前0.5 h口服格列美脲片，初始剂量1 mg，最大剂量不超过6 mg/d，1次/d。两组患者均连续治疗3个月。观察两组临床疗效，同时比较治疗前后两组患者空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）和胰岛β细胞功能指数（HOMA-β）水平。结果 治疗后，对照组和治疗组的总有效率分别是84.38%、96.88%，两组比较差异有统计学意义（P<0.05）。治疗后，两组FBG、2 h PG、HbA1c、FINS、2 h INS和HOMA-IR均较治疗前显著降低，HOMA-β较治疗前显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗后治疗组这些指标水平明显优于照组，两组比较差异具有统计学意义（P<0.05）。结论 格列美脲联合沙格列汀可显著降低2型糖尿病患者血糖，改善胰岛素抵抗和胰岛β细胞功能，无明显药物不良反应。

Objective To investigate the clinical efficacy and safety of glimepiride combined with saxagliptin in treatment of type 2 diabetes. Methods Patients (64 cases) with type 2 diabetes in Xuhui District Central Hospital from November 2016 to November 2017 were randomly divided into control and treatment groups, and each group had 32 cases. Patients in the control group were po administered with Saxagliptin Tablets 0.5 h before breakfast, 5 mg/time, once daily. Patients in the treatment group were po administered with Glimepiride Tablets 0.5 h before breakfast on the basis of the control group, the initial dose was 1 mg, and the maximum dose was less than 6 mg/d, once daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and FBG, 2 h PG, HbA1c, FINS, HOMA-IR, and HOMA-β levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 84.38% and 96.88%, and there were differences between two groups (P<0.05).. After treatment, the FBG, 2 h PG, HbA1c, FINS, 2 h INS, and HOMA-IR levels in two groups were significantly decreased, and HOMA-β levels were significantly increased, and the difference was statistically significant in the same group. And these indexes in the treatment group after treatment were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Glimepiride combined with saxagliptin in treatment of type 2 diabetes can significantly reduce blood glucose, improve insulin resistance and β-cell function without significant adverse reactions.