目的 探讨奥利司他胶囊联合西格列汀二甲双胍片治疗肥胖型2型糖尿病的临床疗效。方法 选取2016年3月—2017年3月华中科技大学同济医学院附属协和医院收治的141例患者，随机分为对照组（70例）和治疗组（71例）。对照组患者口服西格列汀二甲双胍片，1片/次，2次/d。治疗组在对照组的治疗基础上口服奥利司他胶囊，1粒/次，3次/d。两组患者均连续治疗12周。观察两组患者的临床疗效，比较两组患者治疗前后空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、稳态模型胰岛素抵抗指数（HOMA-IR）和稳态模型胰岛β细胞功能指数（HOMA-β）的变化情况。结果 治疗后，对照组和治疗组的总有效率分别为84.29%、95.77%。两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的FPG、2 h PG、HbA1c、TC、TG、LDL-C、HOMA-IR、体质量指数水平均较治疗前显著降低（P<0.05），HDL-C、HOMA-β水平升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组患者FPG、2 h PG、HbA1c、TC、TG、LDL-C、HOMA-IR、体质量指数低于对照组，HDL-C、HOMA-β水平高于对照组，两组比较差异具有统计学意义（P<0.05）。结论 奥利司他胶囊联合西格列汀二甲双胍片治疗肥胖型2型糖尿病具有较好的临床疗效，可显著改善患者血糖水平，安全性较高，具有一定的临床推广应用价值。

Objective To investigate the efficacy of Orlistat Capsules combined with Sitagliptin Phosphate/metformin Hydrochloride Tablets in treatment of obesity type 2 diabetes. Methods Patients (141 cases) with obesity type 2 diabetes in Tongji Medical College Affiliated Union Hospital of Huazhong University of Science and Technology from March 2016 to March 2017 were randomly divided into control (70 cases) and treatment (71 cases) groups. Patients in the control group were po administered with Sitagliptin Phosphate/metformin Hydrochloride Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Orlistat Capsules on the basis of the control group, 1 grain/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HDL-C, HOMA-IR, and HOMA-β in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group were 84.29% and 95.77%, and there were differences between two groups (P < 0.05). After treatment, FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HOMA-IR, and body mass index in two groups were significantly decreased, but HDL-C, HOMA-β were significantly increased, and there were differences in the same group (P < 0.05). After treatment, FPG, 2 h PG, HbA1c, TC, TG, LDL-C, HOMA-IR, and body mass index in the treatment group were lower than those in the control group, but HDL-C, HOMA-β in the treatment group were higher than those in the control group, and there were differences between two groups (P < 0.05). Conclusion Orlistat Capsules combined with Sitagliptin Phosphate/metformin Hydrochloride Tablets has significant clinical effect in treatment of obesity type 2 diabetes, and can significantly improve the blood glucose level with high safety, which has a certain clinical application value.