目的 探究恩格列净联合吡格列酮治疗2型糖尿病的临床疗效。方法 选取2018年6月-2019年5月于郑州人民医院接受治疗的2型糖尿病患者98例，随机分为对照组和治疗组，每组各49例。对照组于每日早餐前口服盐酸吡格列酮片，30 mg/次，1次/d。治疗组在对照组治疗基础上口服恩格列净片，10 mg/次，1次/d。两组治疗时间均为3个月。观察两组的临床疗效，比较两组治疗前后血糖相关指标、氧化产物和抗氧化指标的变化情况。结果 治疗后，治疗组总有效率是93.88%明显高于对照组77.55%（P<0.05）。治疗后，两组空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）均出现显著降低（P<0.05）；且治疗组较对照组更低（P<0.05）；治疗后，对照组体质量指数（BMI）略高于治疗前数值，差异无统计学意义；治疗后治疗组BMI显著降低（P<0.05），且治疗组治疗后BMI显著低于对照组（P<0.05）。治疗后，两组超氧化物歧化酶（SOD）、过氧化氢酶（CAT）、总抗氧化能力（T-AOC）均出现显著升高，但丙二醛（MDA）、终末氧化蛋白产物（AOPP）均显著降低（P<0.05）；治疗后，治疗组这些氧化产物和抗氧化指标显著优于对照组（P<0.05）。治疗后，治疗组的不良反应发生率是6.12%，显著低于对照组的20.40%（P<0.05）。结论 恩格列净联合吡格列酮在2型糖尿病患者中的防治效果显著，且可在一定程度上减少不良反应，同时能够明显改善患者氧化-抗氧化平衡，具有一定的临床推广应用价值。

Objective To explore the efficacy of empagliflozin combined with pioglitazone in treatment of type 2 diabetes. Methods A total of 98 patients with type 2 diabetes treated in Zhengzhou People's Hospital from June 2018 to May 2019 were selected and randomly divided into control group and treatment group, with 49 patients in each group. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets, 30 mg/time, once daily. Patients in the treatment group were po administered with Empagliflozin Tablets on the basis of the control group, 10 mg/time, once daily. The duration of treatment in both groups was 3 months. The clinical efficacy of the two groups was observed, and the changes of blood glucose related indexes, oxidation products and antioxidant indexes before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 93.88%, significantly higher than that of the control group (77.55%, P<0.05). After treatment, fasting blood glucose (FPG), blood glucose (2 h PG) and glycosylated hemoglobin (HbA1c) were significantly decreased in both groups (P<0.05). The glycemic indexes in treatment group were lower than those in the control group (P<0.05). After treatment, the body mass index (BMI) of the control group was slightly higher than that before treatment, and the difference was not statistically significant. BMI of the treatment group was significantly reduced after treatment (P<0.05), and BMI of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (T-AOC) were significantly increased in both groups, but malondialdehyde (MDA) and terminal oxidizing protein product (AOPP) were significantly decreased in both groups (P<0.05). After treatment, the oxidation products and antioxidant indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the incidence of adverse reactions in the treatment group was 6.12%, significantly lower than that in the control group (20.40%, P<0.05). Conclusion Empagliflozin combined with pioglitazone has significant prevention and treatment effect in treatment of type 2 diabetes, and can reduce adverse reactions to a certain extent, and can significantly improve the patient's oxidation-antioxidant balance, which has certain clinical application value.

R977

河南省医学科技攻关计划联合共建项目（2018020817）