【摘要】 目的 探讨埃索美拉唑联合达格列净治疗胰岛素抵抗型糖尿病合并胃食管反流病（gastroesophageal reflux disease, GERD）患者的临床应用价值。方法 回顾性选取2018年1月—2023年2月昭通市第一人民医院收治的86例胰岛素抵抗型糖尿病合并GERD患者的临床资料，根据治疗方案的不同分为对照组和观察组，每组43例。对照组予以埃索美拉唑+二甲双胍治疗，观察组在对照组基础上加用达格列净，两组均连续治疗1个月。比较两组治疗前后血脂、血糖、胰岛功能水平。结果 治疗后，两组血脂、血糖、免疫功能水平均有所改善，观察组的糖化血红蛋白[（6.45±0.96）%]、空腹血糖[（6.54±0.98）mmol/L]、餐后2 h血糖[（8.42±1.26）mmol/L]均低于对照组，差异有统计学意义（t=5.235、4.097、4.624,P<0.05）；与对照组相比，观察组的三酰甘油、总胆固醇、低密度脂蛋白胆固醇和胰岛素抵抗指数水平均较低，而高密度脂蛋白胆固醇、胰岛β细胞功能指数水平均较高，差异有统计学意义（P<0.05）。结论 给予胰岛素抵抗型糖尿病合并GERD患者埃索美拉唑联合达格列净治疗，有利于改善患者的血脂、血糖水平和胰岛素抵抗。更多还原

【Abstract】 Objective To explore the clinical application value of esomeprazole combined with dapagliflozin in the treatment of insulin-resistant diabetes mellitus combined with gastroesophageal reflux disease(GERD) patients.Methods Clinical data of 86 patients with insulin resistance diabetes mellitus complicated with GERD admitted to Zhaotong First People’s Hospital from January 2018 to February 2023 were retrospectively selected. According to different treatment plans, the patients were divided into control group and observation group, with 43 cases in each group. The control group was treated with esomeprazole + metformin, and the observation group was additionally treated with daglipin on the basis of the control group. Both groups were treated continuously for 1 month. The levels of blood lipid, blood glucose and islet function before and after treatment were compared between two groups. Results After treatment, the levels of blood lipids, blood sugar and immune function were improved in both groups, the glycosylated hemoglobin [(6.45±0.96)%], fasting blood glucose [(6.54±0.98) mmol/L], and 2-hour postprandial blood glucose [(8.42±1.26) mmol/L] in observation group were lower than those in control group, the difference was statistically significant(t=5.235, 4.097, 4.624, P<0.05). Compared with the control group, the levels of triacylglycerol, total cholesterol, low density lipoprotein cholesterol and insulin resistance index were lower in the observation group, while the levels of high density lipoprotein cholesterol and islet beta cell function index were higher, the difference was statistically significant(P<0.05). Conclusion The administration of esomeprazole combined with dapagliflozin in patients with insulin-resistant diabetes mellitus combined with GERD is favorable to improve the patients’ lipids, blood glucose levels and insulin resistance.更多还原