磷酸西格列汀联合二甲双胍治疗2型糖尿病疗效及安全性的Meta分析

Efficacy and safety of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus:a meta analysis

目的系统评价磷酸西格列汀(SITA)联合二甲双胍(MET)治疗2型糖尿病(T2DM)的疗效及安全性。方法检索中国知网、万方、维普3个中文数据库,Pub Med,Cochrane Library,MEDLINE,等外文数据库。纳入国内外有关SITA+MET与MET单用治疗T2DM的临床随机对照试验。评价纳入研究的方法学质量,提取符合纳入标准的数据,采用RevMan 5.3软件进行Meta分析。结果共纳入20项研究,3 359例患者。Meta分析结果:与单用MET相比,SITA+MET可明显降低空腹血糖(FBG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、胰岛素抵抗指数(HOMA-IR),但升高空腹胰岛素(FINS)两者差异无统计学意义。与单用MET比较,SITA+MET低血糖发生率无明显升高,胃肠道反应发生率则明显降低。结论SITA+MET可明显降低T2DM患者FBG、2hPG、HbA1c、BMI、HOMA-IR水平,低血糖发生率降低,安全性高,胃肠道反应发生率低,患者耐受性更好。

Objective To assess the effects and safety of sitagliptin combined with metformin in treating type 2 diabetes mellitus （T2DM）.Methods CNKI,Wanfang,VIP,PubMed,Cochrane Library,MEDLINE and other foreign language database were serached.The randomized controlled studies both at home and abroad about the efficacy and safety of sitagliptin combined with metformin and metformin alone in treating T2DM were enrolled into this study. The methodological value of the included studies were j udged,the data conformed to the standard were extracted and RevMan 5.3 software was performed.Results A total of 20 studies were included （n=3359）.Compared with MET alone,SITA＋MET obviously reduced the fasting blood glucose （FBG）,postprandial 2 hours blood glucose （2 hPG）, glycosylated hemoglobin （HbA1c）,body mass index （BMI）and insulin resistance index （HOMA-IR）,but no significant difference was found in fasting plasma insulin（FINS）;SITA＋MET had no obvious increase in the incidence of hypoglycemia,gastrointestinal reaction rate was significantly reduced.Conclusion SITA＋MET can obviously reduce FBG,2 hPG,HbA1 c,BMI and HOMA-IR of T2DM patients,the incidence of hypoglycemia is low,so it has higher safety and low incidence of gastrointestinal reaction,the patients have better tolerability.