胰岛素强化治疗与口服降糖药对比治疗糖尿病性勃起功能障碍的系统评价

Insulin intensive therapy compared with oral medications to treat diabetic erectile dysfunction: A Systematic Review

目的:系统评价胰岛素强化治疗与口服降糖药比较糖尿病性勃起功能障碍(DMED)的临床疗效。方法:计算机检索Pub Med、Nature、Cell、Pub Med.cn、VIP、Wan Fang Data、CNKI数据库,并手工检索相关领域的杂志,收集胰岛素强化治疗与口服降糖药对比治疗DMED临床随机对照试验(RCT),检索时限均从建库至2015年4月。由两名评价员按照纳入与排除标准独立筛选文献,提取资料并评价纳入研究的方法学质量后,采用Rev Man5.2软件进行Meta分析。结果:检索符合纳入胰岛素强化治疗与口服降糖药对比治疗DMED的随机对照试验论文共4篇,总共308例糖尿病性勃起功能障碍患者。Meta分析结果显示:试验组与对照组治疗前IIEF-5评分、血清睾酮、空腹血糖差异均无统计学意义(P>0.05),可用于治疗前后疗效的比较;而试验组与对照组治疗前Hb Alc差异有统计学意义(P<0.05),不能用于治疗前后疗效的比较;试验组与对照组治疗后IIEF-5评分、空腹血糖差异均有统计学意义(P<0.05),而治疗后血清睾酮差异无统计学意义(P>0.05)。结论:现有证据表明,胰岛素强化治疗可以有效治疗DMED。

Objective To systematically review the effectiveness of that Insulin intensive therapy compared with oral medica-tions to treat diabetic erectile dysfunction.Method We conducted electronic searching on PubMed,Nature,Cell,PubMed.cn,VIP, WanFang Data and CNKI from the dates of their establishment to April 2015.Literature screening according to the inclusion and ex-clusion criteria,data extraction and methodological quality assessment of the included studies were completed by two reviewers inde-pendently.Meta -analysis was conducted using RevMan 5.2 software.Results Researching the randomized controlled trials theses that fit the RCTs inclusion criteria in treating diabetic erectile dysfunction with Insulin intensive therapy compared with oral medica-tions,total of 308 cases were enrolled.The results of meta -analysis indicated that：before treatment,experimental group and control group ′s IIEF -5 score,serum testosterone and fasting glucose had no statistical significance （P 〉0.05）,so they can be used to compare the efficacy of before and after the treatment.However,control group and test group ′s HbAlc differences had statistically significant （P 〈0.05）,hence,they cannot be used to compare the efficacy of before and after the treatment.After treatment,experi-mental group and control group ′s IIEF -5 score and fasting glucose differences had statistically significance （P 〈0.05）,but there was no statistically significant difference the serum testosterone （P 〉0.05）.Conclusion Current evidence suggests that insulin in-tensive therapy can effectively treat diabetic erectile dysfunction.