目的 探讨卡格列净联合那格列奈治疗2型糖尿病的临床疗效。方法 选取2022年4月—2023年6月聊城市第二人民医院收治的96例2型糖尿病患者，依据用药差异分为对照组（48例）和治疗组（48例）。对照组餐前口服那格列奈片，120 mg/次，3次/d。在对照组的基础上，治疗组口服卡格列净片，100 mg/次，1次/d；两组患者连续用药12周。观察两组患者的临床疗效，比较治疗前后两组患者血糖代谢指标：空腹血糖（FBG）、餐后2 h血糖（PBG）、糖化血红蛋白（HbA1c）和空腹胰岛素（FINS），2型糖尿病患者生活质量量表评分（DMQLS）、胰岛素抵抗指数（HOMA-IR）及血清单核细胞趋化蛋白-1（MCP-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和胰高血糖素样肽-1（GLP-1）水平。结果 治疗后，治疗组总有效率为95.83%，明显高于对照组的83.33%（P＜0.05）。治疗后，两组患者FBG、PBG、HbA1c、FINS、MCP-1、IL-6、TNF-α水平和HOMA-IR指数均明显降低，而GLP-1水平和DMQLS评分明显升高（P＜0.05），且治疗后治疗组这些指标均明显好于对照组（P＜0.05）。结论 卡格列净与那格列奈协同治疗时，能极大纠正升高的血糖，患者胰岛素分泌得以改善，生活质量提升明显，机体炎性因子含量减弱。

Objective To explore the clinical effect of canagliflozin combined with nateglinide in treatment of type 2 diabetes. Methods Patients (96 cases) with type 2 diabetes in the Second People's Hospital of Liaocheng from April 2022 to June 2023 were divided into control (48 cases) and treatment (48 cases) group based on different treatments. Patients in the control group were po administered with Nateglinide Tablets, 120 mg/time, three times daily. Patients in the treatment group were po administered with Canagliflozin Tablets on the basis of the control group, 100 mg/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, the blood glucose metabolism indicators FBG, PBG, HbA1c and FINS, DMQLS scores and HOMA-IR indexes, and the levels of MCP-1, IL-6, TNF-α and GLP-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.83%, which was significantly higher than that of the control group (83.33%, P < 0.05). After treatment, the levels of FBG, PBG, HbA1c, FINS, MCP-1, IL-6, TNF-α and HOMA-IR index were significantly decreased, while GLP-1 level and DMQLS score were significantly increased in two groups (P < 0.05), and the indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The combination of categlinide and nateglinide can greatly correct the elevated blood sugar, improve the insulin secretion, improve the quality of life and decrease the content of inflammatory factors.

R977

山东省科学技术成果评价项目（鲁科成评字2022-187）