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目的:研究二肽基肽酶4（DPP-4）抑制剂联合地特胰岛素（ID）治疗血糖控制不佳的2型糖尿病（T2DM）的疗效及对血糖和氧化应激指标的影响。方法:选取余姚市中医医院2017年8月至2019年9月收治的口服降糖药治疗血糖控制不佳的T2DM患者105例为观察对象，采用随机数字表法分为对照组（53例）与研究组（52例），对照组患者使用ID+复合维生素治疗，研究组患者使用DPP-4抑制剂（西格列汀）+ID治疗。比较两组患者治疗3个月后临床疗效，治疗前、治疗3个月后血糖指标［空腹血糖（FPG）、餐后2 h血糖（2 h PG）］、糖化血红蛋白（GHb）］、胰岛β细胞功能［胰岛β细胞功能指数（HOMA-β）和胰岛素抵抗指数（HOMA-IR）］、氧化应激指标［超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、脂质过氧化氢（LHP）、丙二醛（MDA）］，并记录用药期间低血糖发生情况。结果:治疗3个月后，研究组总有效率［92.31%（48/52）］显著高于对照组［77.36%（41/53）］（χn 2=4.541，n P<0.05）。治疗3个月后，两组FPG、2 h PG、GHb、HOMA-IR、LHP、MDA水平均较治疗前显著下降，而HOMA-β、SOD、GSH-Px均上升（均n P<0.05），且研究组上述指标与同期对照组比较，差异均有统计学意义（n t=2.902、3.539、5.215、7.313、6.269、4.475、6.050、3.323、5.375，均n P<0.05）。治疗期间，研究组低血糖发生率为0.00%（0/52），显著低于对照组的11.54%（6/53）（χn 2=4.319，n P<0.05）。n 结论:应用DPP-4抑制剂联合地特胰岛素治疗血糖控制不佳的2型糖尿病患者效果显著，可有效控制患者血糖，改善氧化应激指标，且安全性较高，具有较好的应用价值。“,”Objective:To investigate the efficacy of dipeptidyl peptidase 4 inhibitor combined with insulin detemir (ID) in the treatment of type 2 diabetes mellitus with poor blood glucose control and its effects on blood glucose and oxidative stress indicators.Methods:A total of 105 patients with poor blood glucose control after taking oral hypoglycemic drugs who received treatment between August 2017 and September 2019 were included in this study. They were randomly assigned to receive treatment with either ID and compound vitamins (control group, n n = 53) or dipeptidyl peptidase 4 inhibitor sitagliptin and ID (study group, n n = 52). After 3 months of treatment, the clinical efficacy was compared between the control and study groups. Before and after 3 months of treatment, blood glucose indexes [fasting plasma glucose, 2-hour postprandial blood glucose], glycosylated hemoglobin, islet β-cell function [homeostasis model assessment-beta and homeostasis model assessment of insulin resistance)], oxidative stress index [superoxide dismutase, glutathione peroxidase, lipid hydroperoxides, malondialdehyde were compared between the two groups. The incidence of hypoglycemia was also recorded in each group.n Results:After 3 months of treatment, total effective rate in the study group was significantly higher than that in the control group [92.31% (48/52) n vs. 77.36% (41/53), n χ2 = 4.541, n P < 0.05]. After 3 months of treatment, fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance, lipid hydroperoxide and malondialdehyde levels in each group were significantly decreased, homeostasis model assessment-beta, superoxide dismutase and glutathione peroxidase levels were significantly increased compared with before treatment (all n P < 0.05). There were significant significances in these indexes measured concurrently between the study and control groups ( n t = 2.902, 3.539, 5.215, 7.313, 6.269, 4.475, 6.050, 3.323, 5.375, all n P < 0.05). During the treatment, the incidence of hypoglycemia in the study group was significantly lower than that in the control group [0.00% (0/52) n vs. 11.54% (6/53), n χ2 = 4.319, n P < 0.05].n Conclusion:Dipeptidyl peptidase 4 inhibitor combined with insulin detemir is highly effective for type 2 diabetes mellitus with poor blood glucose control. It can effectively control blood glucose level, improve oxidative stress reaction and is highly safe. Therefore, this treatment method is of good application value.