门冬胰岛素联合维生素D治疗妊娠期糖尿病Meta分析

Meta-analysis on Men Dong Insulin Combined with Vitamin D in Treatment of Gestational Diabetes Mellitus

目的:评价门冬胰岛素联合维生素D治疗妊娠糖尿病(GDM)的有效性和安全性,为临床选择用药提供循证医学依据。方法:通过检索中英文医学数据库随机对照试验(RCTs),检索时间自建库以来到2020年4月。由2名研究者进行文献筛选,对符合标准的研究进行评价分析。结果:研究最终纳入11篇RCT,共纳入1084例患者。在临床有效率[RR=1.18,95%CI(0.87,1.60),P=0.29]、空腹血糖(FPG)[MD=-1.00,95%CI(-1.35,-0.66),P<0.00001]、餐后2h血糖(2h-PBG)[MD=-1.64,95%CI(-2.18,-1.09),P<0.00001]、糖化血红蛋白(HbA1c)[MD=-1.49,95%CI(-1.96,-1.02),P<0.00001],观察组治疗效果要优于对照组。不良反应发生率方面,观察组明显低于对照组发生率[RR=0.36,95%CI(0.27,0.48),P<0.00001]。结论:门冬胰岛素联合维生素D在有效率、血糖相关指标、不良反应发生率等方面具有显著的效果。由于纳入的文献质量较低、样本数据较少,还需更大样本量、质量高的随机对照双盲试验进一步验证。

Objective To evaluate the effectiveness and safety of GDM with insulin and vitamin D in the treatment of GDM to provide evidence-based medical reference for clinical drug selection.Method We searched for RCTs in a medical database in both English and Chinese.Literature was screened by 2 researchers to evaluate and analyze studies that met the criteria.Result A total of 11 RCTs were included in the study.In the clinical response rate,FPG,2h-PBG,HbA1c,the treatment effect of the observation group was better than the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group.Conclusion The combination of Men Dong insulin and vitamin D had significant effects on the effective rate,blood glucose related indexes and the incidence of adverse reactions.However,due to that the low quality of the included literature and small sample data,hence,it s need for further verification use to a large of sample size and high quality randomized controlled double-blind trial.