摘要
目的系统评价吡格列酮联合二甲双胍治疗2型糖尿病的有效性及安全性。方法计算机检索The Cochrane Library(2015年9期)、Pub Med、EMbase、CNKI、Wan Fang Data和VIP数据库,检索时限从建库至2015年9月,搜集吡格列酮联合二甲双胍与磺脲类药物联合二甲双胍治疗2型糖尿病的相关随机对照试验(RCT)。由2名评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入7个RCT,3 005例患者。Meta分析结果显示:当疗程≤?24周时,与磺脲类联合二甲双胍治疗相比,吡格列酮联合二甲双胍治疗患者Hb A 1 c水平相当[MD=–0.04,95%CI(–0.26,0.19),P=0.74],但发生低血糖风险更低[RR=0.39,95%CI(0.15,1.01),P=0.05]。疗程>24周仅纳入1个研究,未进行Meta分析。结论吡格列酮联合二甲双胍与磺脲类联合二甲双胍控制血糖的疗效相当,但低血糖发生率降低。受纳入研究数量和质量所限,上述结论可能存在偏倚,需开展更多高质量研究予以验证。
Objective To evaluate the efficacy and safety of piolitazone combined with metformin for type 2 diabetes mellitus. Methods The Cochrane Library(Issue 9, 2015), Pub Med, EMbase, CNKI, Wan Fang Data and VIP databases were searched up to September 2015 for randomized controlled trials(RCTs) about pioglitazone combined with metformin versus sulfonylurea combined with metformin for type 2 diabetes mellitus. Two reviewers independently screened literature, extracted date, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Rev Man 5. 3 software. Results A total of 7 RCTs involving 3 005 patients were included. The results of metaanalysis showed that when the course of treatment was ≤ 24 weeks, no significant difference was found in the level of Hb A 1 c between the piolitazone plus metformin group and the sulphonylurea plus metformin group(MD= – 0. 04, 95 %CI – 0. 26 to 0. 19, P= 0. 74), but the piolitazone plus metformin group had lower risk of hypoglycemia(RR= 0. 39, 95 %CI 0. 15 to 1. 01, P= 0. 05); when the course of treatment 〉24 weeks, only one RCT was included, we didn't conduct pool analysis. Conclusion Piolitazone combined with metformin has similar effect to sulphonylurea combined with metformin in controlling blood sugar, but piolitazone combined with metformin has lower incidence of hypoglycemia. Due to limited quality and quantity of the included studies, the above conclusion need to be verified by more high quality studies.
出处
《中国循证医学杂志》
CSCD
2016年第10期1148-1153,共6页
Chinese Journal of Evidence-based Medicine
关键词
吡格列酮
2型糖尿病
META分析
系统评价
随机对照试验
Piolitazone
Type 2 diabetes mellitus
Meta-analysis
Systematic review
Randomized controlled trial