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以二甲双胍为基础的固定复方制剂治疗2型糖尿病的研究进展
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Abstract:
2型糖尿病(T2DM)是一种病因不明的慢性代谢性疾病，二甲双胍常作为T2DM患者控制高血糖的一线用药和药物联合中的基本用药。当单药治疗血糖不达标时，指南推荐两种降糖药物联合治疗。但多种药物自由联合可能导致患者治疗依从性差，进而导致血糖控制不足。而固定复方制剂(FDC)的出现为简化复杂治疗方案，实现精准治疗提供了新的途径。本文就以二甲双胍为基础FDC治疗T2DM的作用机制、临床疗效作一综述。结果表明FDC可以通过不同机制协同降糖，相比单药治疗具有更高效的降糖效果、良好的生物等效性和安全性。FDC具有覆盖多重高血糖病因、简化治疗方案、促进合理用药、克服临床惰性、提高患者依从性等诸多优势，是未来临床治疗T2DM用药发展的方向之一。
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease of unknown etiology. Metformin is often used as a first-line agent for hyperglycemia control in patients with T2DM and as an essential agent in drug combinations. The guidelines recommend a combination of two hypoglycemic agents when blood glucose is not met with monotherapy. However, the free combination of multiple medications may lead to poor patient adherence to therapy, which in turn leads to inadequate glycemic control. The emergence of fixed-dose combination (FDC) provides a new way to simplify complex treatment protocols and achieve precision therapy. This article provides a review of the mechanism of action and clinical efficacy of metformin-based FDC for the treatment of T2DM. The results show that FDC can synergize glucose lowering through different mechanisms, and has more efficient glucose-lowering effect, good bioequivalence and safety compared with monotherapy. FDC has many advantages such as covering multiple causes of hyperglycemia, simplifying the treatment plan, promoting rational drug use, overcoming clinical inertia, and improving patient compliance. It is one of the future directions for the development of clinical treatment of T2DM.
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