3种胃肠重建方式对2型糖尿病降糖效果的meta分析

Hypoglycemic effects of three types of gastrointestinal reconstruction on type 2 diabetes mellitus: a meta-analysis

目的对比毕Ⅰ式、毕Ⅱ式、Roux-en-y胃肠重建手术对2型糖尿病降糖效果。方法检索中国生物医学文献数据库、中文生物医学期刊文献数据库、中国知网、维普、万方、MEDLINE,1994-01至2013-10发表的不同消化道重建手术对2型糖尿病疗效对比的文献,筛选、提取、质量评价,用RevMan5.0软件进行meta分析。结果共有7篇文献入选,病例总数378例,毕Ⅰ式74例,毕Ⅱ式184例,Roux-en-y120例。meta分析结果:(1)毕Ⅰ式、毕Ⅱ式以及Roux-en-y术后3个月血糖水平均明显低于术前;(2)毕Ⅰ式与毕Ⅱ式术后3个月血糖水平无差别;(3)毕Ⅰ式术后3个月血糖水平明显高于Roux-en-y;(4)毕Ⅱ式与Roux-en-y术后3个月血糖水平无差别;(5)毕Ⅰ式术后6个月血糖水平明显高于毕Ⅱ式和Roux-en-y;(6)毕Ⅱ式与Roux-en-y相比术后6个月血糖水平无差别;(7)毕Ⅰ式术前与术后6个月血糖水平无差别;(8)毕Ⅱ式和Roux-en-y术后6个月血糖水平均明显低于术前;(9)毕Ⅱ式与Roux-en-y术后6个月糖尿病治疗有效率无差别。结论毕Ⅱ式和Roux-en-y对2型糖尿病的治疗均有效。

Objective To compare the hypoglycemic effects of Billroth Ⅰ , Billroth Ⅱ , Roux-en-y gastrointestinal reconstruction t^perations on type 2 diabetes mellitus. Methods The literature（ 1994.01-2013. 10）was searched about different digestive tract reconstruction operations published on the comparison of curative effect of type 2 diabetes mellitus in CBM, CMCC,CNKI, VIP, WAN- FANG, MEDI,INE, then screened, extracted, quality was evaluated. Meta-analysis was performed by using RevManS. 0 software. Resuits A total of 7 articles were selected. The total numbers of cases in 378 cases ,were 74 in Billroth Ⅰ , 184 in Billroth Ⅱ , and 120 in Roux-en-y. The results of meta-analysis were as follows ： （ 1 ） The blood glucose levels in Billroth Ⅰ, Billroth Ⅱ and Roux-en-y in the third month after operation were significantly lower than those preoperation. （2） No difference in blood glucose levels between Billroth Ⅰ and Billroth Ⅱ in the third month after operation. （3） The blood glucose levels in Billroth I were significantly higher than those of Roux-en-y in the third month after operation. （4） No difference in blood glucose levels between Billroth II and Roux-en-y in the third month after operation. （5） Half a year after operation , the blood glucose level of Billroth I was significantly higher than that of Billroth Ⅱ and Roux-en-y. （6） Compared with Billroth Ⅱ and Roux-en-y, no difference in blood glucose levels after half a year of the operation. （7） Comparism of preoperation and six months after Billroth I operation, showed no difference in blood glucose. （8） The blood glucose levels of Billroth Ⅱ and Roux-en-y after half a year of the operation were significantly lower than that of the preoperation. （9） For Billroth Ⅱ compared with Roux-en-y, there were no differences in diabetes treatment results. Conclusions The Billroth Ⅱ and Roux-en-y operations for the treatment of type 2 diabetes mellitus are effective.