恩格列净用于1型糖尿病疗效的循证评价

Evidence-based evaluation of the efficacy of Empagliflozin in type 1 diabetes

目的系统评价恩格列净在1型糖尿病患者中应用的有效性和安全性,以期为临床用药提供参考。方法以Empagliflozin、type 1 diabetes、恩格列净、1型糖尿病为检索词,计算机检索EMbase、PubMed、Cochrane Library、ClinicalTrials.gov、中国知网、维普和中国生物医学文献数据库,纳入1型糖尿病患者以恩格列净作为治疗药物的随机对照研究,语种仅限中、英文。文献检索时限均从建库到2020年12月31日。结果共纳入5篇随机对照试验,本次循证研究发现恩格列净能够有效降低1型糖尿病患者的空腹血糖、糖化血红蛋白、体质量及每日胰岛素用量;有效增加24 h的尿糖排泄量及血糖达标持续时间;改善动脉硬化及内皮功能;恩格列净常见的不良反应有低血糖、疲劳和生殖器感染。结论恩格列净在单用最优剂量胰岛素控制血糖不佳的1型糖尿病患者中疗效显著,不良反应小,值得临床进一步开展研究。

Objective This study was designed to systematically evaluate the efficacy and safety of Empagliflozin in patients with type 1 diabetes and provide references for clinical medication. Methods With following search terms such as Empagliflozin,type 1 diabetes in both chinese and english languages,and the references were collected from Embase,PubMed,Cochrane Library,ClinicalTrials. gov,CNKI,Wanfang Data,VIP and CBM from inception to December 31,2020. Randomized controlled studies involving Empagliflozin as therapy in patients with type 1 diabetes were included. Results A total of 5 randomized controlled trials were included. This evidence-based study found that Empagliflozin could effectively reduce the fasting blood glucose,glycosylated hemoglobin,body weight and daily insulin dosage in patients with type 1 diabetes. It can effectively increase 24-hour urinary glucose excretion and the time within glucose target range. Empagliflozin can also improve arterial function and endothelial function. Common side effects of Empagliflozin include hypoglycemia,fatigue,and genital infections. Conclusion Empagliflozin has a significant effect in patients with type 1 diabetes who have poor blood glucose control by using the optimal dose of insulin alone,with few side effects,which is worthy of further clinical study.