宋安民

[摘要] 目的 分析单用瑞格列奈和瑞格列奈联合罗格列酮治疗2型糖尿病的效价比。方法 选择2014年1月—2015年10月该院门诊诊治的2型糖尿病患者190 例，经饮食、运动疗法，未能凑效。随机分为对照组和观察组各95例。两组均采用糖尿病饮食、运动疗法等基础治疗，对照组加服瑞格列奈，观察组在服瑞格列奈的同时，给予罗格列酮。疗程均为12 周。治疗前后常规检查血常规、肝肾功能、心电图、空腹血糖、餐后2 h血糖及糖化血红蛋白。1个疗程治疗结束后进行疗效评定。 结果 观察组95例中显效54例，占56.8%，有效38例，占40.08%，无效3例，占3.2%，总有效率为96.8%；对照组95例中显效43例，占45.3%，有效33例，占34.7%，无效19例，占20.0%（，总有效率为80.0%。观察组总有效率（96.8%）明显高于对照组（80.0%），P<0.05。应用成本-效果分析发现：治疗组单位治疗效果所花费用较对照组少1.1元，经敏感度分析，仍得出相同的结果。 结论 瑞格列奈联合罗格列酮是治疗2型糖尿病的优选方案。

[关键词] 瑞格列奈；罗格列酮；2型糖尿病；效价比；分析

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2016）03（b）-0067-02

[Abstract] Objective To analyze the use of repaglinide and rosiglitazone combined with repaglinide in treatment of type 2 diabetes potency ratio. Methods 2 patients with type 190 diabetes who were treated in our hospital from January 2014 to October were selected and treated by diet and exercise therapy. Randomly divided into control group and observation group of 95 cases. Two groups were treated with basic treatment of diabetes diet， exercise therapy， the control group was taken with repaglinide， the observation group in the service of repaglinide and rosiglitazone. The course of treatment was 12 weeks. Before and after treatment， routine examination of blood， liver and kidney function， ECG， fasting blood glucose， meal 2 hours blood glucose and glycosylated hemoglobin. Efficacy evaluation after 1 courses of treatment. Results The observation group， 95 cases， 54 cases were markedly improved， 56.8%， effective in 38 cases， accounted for 40.08%， 3 cases were ineffective， 3.2%， the total efficiency of 96.8%； control group （95 cases） in 43 cases were markedly effective， accounted for 45.3%， 33 cases were effective， accounting for 34.7%， 19 cases were ineffective and 20.0% （and the total effective rate was 80.0%. The total effective rate of the observation group （96.8%） was significantly higher than that of the control group （80%）， P<0.05. Cost effectiveness analysis showed that the cost of treatment in the treatment group was 1.1 less than that of the control group， and the same results were still obtained after the sensitivity analysis. Conclusion repaglinide and rosiglitazone is preferred in the treatment of type 2 diabetes.

[Key words] Repaglinide； Rosiglitazone； Type 2 diabetes； Cost-effectiveness analysis

糖尿病（ DM）是由于胰岛β细胞分泌胰岛素障碍和外周组织对胰岛素抵抗导致的代谢异常，主要与遗传和生活环境等有关。随着国人生活水平提高，饮食结构改变，现已成为继心血管疾病、恶性肿瘤之后第三位威胁人类健康的非传染性疾病[1]，影响了患者的生活质量。目前多采用运动、饮食、药物等综合治疗，我国是发展中国家，选用既经济又有效的药物是治疗疾病需要关注的重要问题。瑞格列奈和罗格列酮均是治疗2型糖尿病的主要药物，临床应用非常广泛，联合用药能更好控制血糖[2]。2014年1月—2015年10月该院单用瑞格列奈和瑞格列奈联合罗格列酮治疗2型糖尿病患者各95例。……