格列美脲联合二甲双胍治疗2型糖尿病疗效的Meta分析
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摘要
目的探究格列美脲联合二甲双胍治疗2型糖尿病的疗效。方法检索中国知网(CNKI)、PubMed、万方(WangFang)以及维普(VIP)数据库系统文献,入选的研究为2000年1月—2018年7月期间采用格列美脲联用二甲双胍治疗2型糖尿病的随机对照试验,用Jadad量表进行文献质量评价。实验组予格列美脲联用二甲双胍治疗,对照组单用二甲双胍治疗。运用ReviewManager5.3软件对两组治疗结局指标空腹血糖(FBG)、餐后2h血糖(2hPBG)和糖化血红蛋白(Hb A1c)进行Meta比较分析。结果 9篇RCT文献符合纳入标准,实验组和对照组的疗效对比Meta分析结果显示:格列美脲联用二甲双胍在降低FBG、2hPBG和Hb A1c方面优于单用二甲双胍,FBG[MD=1.58,95%CI(1.33,1.83),P<0.00001]、2hPBG[MD=2.10,95%CI(1.73,2.46),P<0.00001]、Hb A1c[MD=1.27,95%CI(0.95,1.59),P<0.00001]。结论格列美脲联合二甲双胍治疗2型糖尿病能更有效降低患者的FBG、2hPBG and Hb A1c,但在安全性方面仍需进一步的探究。
Objective To investigate the efficacy of glimepiride combined with metformin in the treatment of type 2 diabetes mellitus(T2 DM).Methods A systematic literature search on PubMed,CNKI,WangFang and VIP databases was performed.The eligible studies were randomized controlled trials(RCTs)for patients with T2 DM who received the combination treatment of glimepiride and metformin between January 2000 and July 2018,and the Jadad scale was used to evaluate the literature quality.The experimental group was given glimepiride combined with metformin,while the control group was treated with metformin alone.A Meta-analysis was carried out by using ReviewManager5.3 software for comparing and analyzing the treatment outcome indexes such as fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG)and glycosylated hemoglobin A(Hb Alc).Results Nine papers of RCT in accord with the inclusion standards were included in this study.The Meta-analysis results showed that glimepiride combined metformin was superior to metformin alone in lowering FBG,2 hPBG and Hb Alc by comparing the efficacy of the experimental group with the control group,FBG [MD=1.58,95%CI(1.33,1.83),P<0.00001],2 hPBG [MD=2.10,95%CI(1.73,2.46),P<0.00001]and Hb Alc[MD=1.27,95%CI(0.95,1.59),P<0.00001].Conclusion In the treatment of type 2 diabetes mellitus,glimepiride combined with metformin can more effectively reduce FBG,2 hPBG and Hb Alc.But further study is needed on the safety of the combination treatment.
Objective To investigate the efficacy of glimepiride combined with metformin in the treatment of type 2 diabetes mellitus(T2 DM).Methods A systematic literature search on PubMed,CNKI,WangFang and VIP databases was performed.The eligible studies were randomized controlled trials(RCTs)for patients with T2 DM who received the combination treatment of glimepiride and metformin between January 2000 and July 2018,and the Jadad scale was used to evaluate the literature quality.The experimental group was given glimepiride combined with metformin,while the control group was treated with metformin alone.A Meta-analysis was carried out by using ReviewManager5.3 software for comparing and analyzing the treatment outcome indexes such as fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG)and glycosylated hemoglobin A(Hb Alc).Results Nine papers of RCT in accord with the inclusion standards were included in this study.The Meta-analysis results showed that glimepiride combined metformin was superior to metformin alone in lowering FBG,2 hPBG and Hb Alc by comparing the efficacy of the experimental group with the control group,FBG [MD=1.58,95%CI(1.33,1.83),P<0.00001],2 hPBG [MD=2.10,95%CI(1.73,2.46),P<0.00001]and Hb Alc[MD=1.27,95%CI(0.95,1.59),P<0.00001].Conclusion In the treatment of type 2 diabetes mellitus,glimepiride combined with metformin can more effectively reduce FBG,2 hPBG and Hb Alc.But further study is needed on the safety of the combination treatment.
引文
[1]李枝萍,刘军,徐婷婷,等.我国2型糖尿病的流行病学及危险因素研究现状[J].西南军医,2010,12(4):754-756.
[2]American Diabetes Association.Standards of medical care in diabetes-2011[J].Diabetes Care,2011,34(Suppl 1):S11-S61.
[3]Asian-Pacific Type 2Diabetes Policy Group.Type 2diabetes:practical targets and treatments[M].Sydney:Health Communications Australia Pty Limited on behalf of the Asian-Pacific Type 2Diabetes Policy Group,1999.
[4]Juni P,Altman DG,Egger M.Systematic reviews in health care:assessing the quality of controlled clinical trials[J].BMJ,2001,323(7303):42-46.
[5]王国民.格列美脲联合二甲双胍治疗2型糖尿病的疗效观察[J].中国社区医师(医学专业),2012,14(33):126
[6]李鑫.格列美脲联合二甲双胍治疗2型糖尿病的疗效[J].临床医学,2012,32(10):57-58.
[7]王勋,王志强,王毅.格列美脲联合二甲双胍治疗2型糖尿病68例临床研究[J].中国药物经济学,2013(S3):237-238.
[8]孙淑娟.格列美脲与二甲双胍治疗2型糖尿病的临床观察[J].吉林医学,2014,35(5):948-949.
[9]徐永纪.格列美脲联合二甲双胍治疗2型糖尿病39例临床观察[J].中国民族民间医药,2015,24(13):85.
[10]周晓佳,聂明明,井慧珠.格列美脲联用二甲双胍治疗2型糖尿病临床疗效观察[J].中国卫生标准管理,2015,6(24):120-121.
[11]王静.格列美脲联用二甲双胍治疗2型糖尿病的临床疗效[J].辽宁医学杂志,2015,29(3):177-178.
[12]毛泽红,太赛尔格林.格列美脲联合二甲双胍对2型糖尿病患者胰岛素抵抗的影响[J].中外医学研究,2016,14(25):134-135.
[13]陈韵.格列美脲与二甲双胍治疗老年糖尿病的效果研究[J].中国老年保健医学,2017,15(3):41,44.
[14]韩旭亮,王晓雯,郑艳侠,等.2型糖尿病的药物治疗进展[J].西北药学杂志,2012,27(6):616-618.
[15]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[16]American Diabetes Association.Standards of medical care in diabetes-2013[S].Diabetes Care,2013,36(Suppl1):S11-S66.
[17]范国洽,郝慧斌,杨昱,等.2013版《中国2型糖尿病防治指南》解读[J].中国临床医生杂志,2015,43(10):92-94.
[18]颜云湘.第3代磺脲类抗糖尿病药-格列美脲片[J].中国临床药学杂志,2006,15(5):334-335.
[19]薛雪,高家荣,夏伦祝,等.格列美脲不同药物联用治疗2型糖尿病的成本-效果分析[J].安徽医药,2014,18(3):441-443.
[2]American Diabetes Association.Standards of medical care in diabetes-2011[J].Diabetes Care,2011,34(Suppl 1):S11-S61.
[3]Asian-Pacific Type 2Diabetes Policy Group.Type 2diabetes:practical targets and treatments[M].Sydney:Health Communications Australia Pty Limited on behalf of the Asian-Pacific Type 2Diabetes Policy Group,1999.
[4]Juni P,Altman DG,Egger M.Systematic reviews in health care:assessing the quality of controlled clinical trials[J].BMJ,2001,323(7303):42-46.
[5]王国民.格列美脲联合二甲双胍治疗2型糖尿病的疗效观察[J].中国社区医师(医学专业),2012,14(33):126
[6]李鑫.格列美脲联合二甲双胍治疗2型糖尿病的疗效[J].临床医学,2012,32(10):57-58.
[7]王勋,王志强,王毅.格列美脲联合二甲双胍治疗2型糖尿病68例临床研究[J].中国药物经济学,2013(S3):237-238.
[8]孙淑娟.格列美脲与二甲双胍治疗2型糖尿病的临床观察[J].吉林医学,2014,35(5):948-949.
[9]徐永纪.格列美脲联合二甲双胍治疗2型糖尿病39例临床观察[J].中国民族民间医药,2015,24(13):85.
[10]周晓佳,聂明明,井慧珠.格列美脲联用二甲双胍治疗2型糖尿病临床疗效观察[J].中国卫生标准管理,2015,6(24):120-121.
[11]王静.格列美脲联用二甲双胍治疗2型糖尿病的临床疗效[J].辽宁医学杂志,2015,29(3):177-178.
[12]毛泽红,太赛尔格林.格列美脲联合二甲双胍对2型糖尿病患者胰岛素抵抗的影响[J].中外医学研究,2016,14(25):134-135.
[13]陈韵.格列美脲与二甲双胍治疗老年糖尿病的效果研究[J].中国老年保健医学,2017,15(3):41,44.
[14]韩旭亮,王晓雯,郑艳侠,等.2型糖尿病的药物治疗进展[J].西北药学杂志,2012,27(6):616-618.
[15]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[16]American Diabetes Association.Standards of medical care in diabetes-2013[S].Diabetes Care,2013,36(Suppl1):S11-S66.
[17]范国洽,郝慧斌,杨昱,等.2013版《中国2型糖尿病防治指南》解读[J].中国临床医生杂志,2015,43(10):92-94.
[18]颜云湘.第3代磺脲类抗糖尿病药-格列美脲片[J].中国临床药学杂志,2006,15(5):334-335.
[19]薛雪,高家荣,夏伦祝,等.格列美脲不同药物联用治疗2型糖尿病的成本-效果分析[J].安徽医药,2014,18(3):441-443.