溴隐亭治疗2型糖尿病有效性及安全性的Meta分析

Efficacy and safety of Bromocriptine in the treatment of type 2 diabetes mellitus:A meta analysis

目的评价溴隐亭治疗T2DM的有效性及安全性。方法通过检索数据库搜集溴隐亭治疗T2DM的相关随机对照试验(RCT),根据Cochrane系统评价方法对纳入的研究进行质量评价,并使用Rev Man 5.3软件对结果进行Meta分析。结果共纳入8个RCTs,4159例患者。与安慰剂比较,溴隐亭可降低HbA1 c(MD=-0.56,95%CI:-0.65^-0.48,P=0.0004)、FPG(MD=-28.47,95%CI:-46.34^-10.60,P=0.002)及餐后血糖(PPG)水平(P<0.05)。安全性方面,溴隐亭与安慰剂总不良反应发生率(OR=0.88,95%CI:0.70~1.12,P=0.30)及低血糖发生率(OR=1.48,95%CI:0.87~2.50,P=0.14)比较,差异均无统计学意义(P>0.05)。结论溴隐亭可有效控制T2DM患者的血糖,总不良反应事件发生率及低血糖发生率与安慰剂相当。但仍需更多设计严格的大样本随机研究为临床提供更可靠的证据。

Objective To evaluate the efficacy and safety of Bromocriptine in the treatment of type 2 diabetes （T2DM）. Methods Retrieval with computer from the medicine database was performed to collect randomized controlled trails （RCTs） on the treatment of T2DM using bromocriptine versus placebo. The quality of RCTs was evaluated according to the methods of cochrane system review. The results of RCTs were analyzed using Rev Man 5.3 software. Results 12 RCTs involving 4159 patients were included. Meta-analysis showed that bromocriptine significantly reduced haemoglobin A1 c （HbA1 c） （MD=-0. 56,95% CI： - 0. 65 %-- 0. 48, P= 0. 0004）, Fasting blbod-glucose （FPG） （MD=- 28. 47, 95 % CI ：- 46. 34 -- 10.60, P= 0. 002） and postprandial blood glucose （PPG）. In the aspect of safety, there were no significant differences between bromocriptine group and placebo in overall adverse events （OR=0. 88,95% CI：0. 70-1.12,P=0. 30）and hypoglycemic events（OR=1. 48,95% CI：0. 87-2. 50,P =0. 14）. Conclusion Bromocriptine is effective and safe in glycemic control for T2DM patients, with similar incidence of adverse events in placebo. More large studies are needed to provide reliable evidence for clinic practice.