阿格列汀与其他口服降糖药比较治疗2型糖尿病的系统评价

发布时间：2018-03-14 14:18

本文选题：阿格列汀　切入点：降血糖药　出处：《中国新药与临床杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的系统评价阿格列汀与其他口服降糖药治疗2型糖尿病(T2DM)的有效性和安全性。方法计算机检索PubMed、EMbase、Cochrane Library、中国知网、万方、维普等数据库,并手工检索相关期刊杂志,查找以阿格列汀为干预措施治疗T2DM的随机对照试验(RCT)。对符合纳入标准的RCT,按Cochrane系统评价的方法进行资料提取及质量评价,并采用RevMan5.2软件进行Meta分析。结果共纳入9项RCT,共4 381例患者。合并分析结果显示:阿格列汀在降低糖化血红蛋白(HbA_(1c))方面[WMD=-0.47,95%CI(-0.64,-0.29),P0.000 01]及改善胰岛β细胞功能方面[WMD=8.32,95%CI(4.98,11.67),P0.000 01]均优于阳性对照药。亚组分析显示,阿格列汀降低HbA_(1c)的效应优于二甲双胍[WMD=-0.70,95%CI(-0.85,-0.56),P0.000 01]、格列吡嗪[WMD=-0.11,95%CI(-0.20,-0.02),P=0.02]及吡格列酮[WMD=-0.66,95%CI(-0.78,-0.54),P0.000 01]。安全性方面,阿格列汀与阳性对照药相比,引起总不良事件、严重不良事件、心血管不良事件风险均无显著差异(均P0.05),引起低血糖事件的风险亦较低。结论与其他口服降糖药相比,阿格列汀可有效降低T2DM患者的HbA_(1c)水平,并在一定程度上改善胰岛β细胞功能,引发不良事件风险相当。上述结论还需更多的大规模、多中心随机对照试验进一步研究证实。
[Abstract]:Objective to evaluate the efficacy and safety of Aglitine and other oral hypoglycemic drugs in the treatment of type 2 diabetes mellitus (T2DM). A randomized controlled trial with Agletine as an intervention in the treatment of T2DM was conducted. Data extraction and quality evaluation were performed according to the Cochrane system evaluation method for RCTs that met the inclusion criteria. A total of 4 381 patients were included in the Meta analysis with RevMan5.2 software. The combined analysis showed that Agletine was effective in reducing HbA1C (HbA1C) and improving the function of islet 尾 cells [WMD-8.32CI4.89 / 11.67P0.00001]. Positive control drug. Subgroup analysis showed that, The effect of Aglestine on reducing HbA1 cwas superior to that of metformin (WMD-0.7095CI-0.85U -0.56 P0.00001), glipizide (WMD-0.1195CI-0.20CI-0.02P0.02) and pioglitazone [WMD-0.66Con 95CI-0.78U -0.54P0.00001]. In terms of safety, Agletine caused total adverse events and serious adverse events compared with the positive control drug. There was no significant difference in the risk of cardiovascular adverse events (all P0.05N, the risk of hypoglycemic events was lower. Conclusion compared with other oral hypoglycemic drugs, Aglutin can effectively reduce the level of HbADP 1cin in patients with T2DM. To some extent, the function of islet 尾 cells was improved and the risk of adverse events was equal. These conclusions need to be further confirmed by multi-center randomized controlled trials.
【作者单位】：四川省骨科医院药剂科;西南医科大学附属医院药剂科;
【分类号】：R587.1

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