维生素B_1辅助治疗2型糖尿病疗效的Meta分析

Therapeutic efficacy of vitamin B_1 for adjunctive treatment in type 2 diabetes mellitus: a meta-analysis

目的系统评价维生素B1辅助治疗2型糖尿病的疗效。方法计算机检索Pub Med、EMbase、The Cochrane Library、CNKI、VIP、Wan Fang Data和CBM数据库,搜集维生素B1辅助治疗2型糖尿病的随机对照试验(randomized controlled trials,RCTs),检索时限均为建库至2017年7月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3和Stata 12.0软件进行Meta分析。结果纳入6个RCTs,共346例患者。Meta分析结果显示,与对照组相比,维生素B1辅助组的C反应蛋白(CRP)明显改善[MD=–1.09,95%Cl(–1.63,–0.54),P<0.000 1],但在空腹血糖[MD=–0.23,95%Cl(–0.58,0.13),P=0.22]、糖化血红蛋白[MD=0.13%,95%CI(–0.25,0.52),P=0.49]、2小时血糖[MD=–0.18,95%CI(–1.03,0.67)P=0.68]、收缩压[MD=2.94,95%Cl(–1.31,7.18),P=0.18]、舒张压[MD=–1.60,95%Cl(–4.24,1.05),P=0.24]、甘油三酯[MD=–0.12,95%Cl(–0.32,0.09),P=0.27]、总胆固醇[MD=0.21,95%Cl(–0.05,0.46),P=0.12]、高密度脂蛋白胆固醇[MD=0.03,95%Cl(–0.07,0.12),P=0.56]、低密度脂蛋白胆固醇[MD=0.12,95%Cl(–0.11,0.35),P=0.30]方面,两组差异均无统计学意义。结论当前证据显示,维生素B1辅助治疗2型糖尿病对患者血糖的控制、血压、血脂的影响并不显著。受纳入研究的数量和质量的限制,上述结论尚待开展更多高质量的研究予以验证。

Objectives To systematically review the therapeutic efficacy of vitamin B1 for adjunctive treatment in type 2 diabetes mellitus. Methods Databases including PubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM were searched to collect randomized controlled trials （RCTs） on vitamin BI for adjunctive treatment in type 2 diabetes mellitus from inception to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted by RevMan 5.3 and Stata 12.0 softwares.Results A total of 6 RCTs involving 346 patients were included. The results of meta-analysis showed that, compared with the control group, the vitamin Bl adjunctive group had a significant improvement in CRP （MD=-I.09, 95%CI -1.63 to -0.54, P〈0.000 1）. However, the fasting blood glucose （MD=-0.23, 95%CI -0.58 to 0.13, P=0.22）, glycosylated hemoglobin （MD=0.13, 95%CI -0.25 to 0.32, P=0.49）, 2 hours plasma glucose （MD=-0.18, 95%CI -1.03 to 0.67, P=0.68）, systolic pressure （MD=2.94, 95%CI -1.31 to 7.18, P=0.18）, diastolic pressure （MD=-I.60, 95%C! -4.24 to 1.05, P=0.24）, triglycerides （MD=-0.12, 95%CI -0.32 to 0.09, P=0.27）, total cholesterol （MD=0.21, 95%CI -0.05 to 0.46, P=0.12）, high- density lipoprotein cholesterols （MD=0.03, 95%CI -0.07 to 0.12, P=0.56） and low-density lipoprotein cholesterols （MD=0.12, 95%CI -0.11 to 0.35, P-0.30） had no significant differences between both groups. Conclusions Vitamin Bl adjunctive treatment could not improve the levels of blood glucose, blood pressure and serum lipids. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.