在二甲双胍治疗基础上DPP-4抑制剂与其它类型降糖药物的疗效和安全性Meta分析

发布时间：2018-05-16 13:10

本文选题：DPP-4抑制剂 + 二甲双胍　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的比较DPP-4抑制剂+二甲双胍和其他降糖药物+二甲双胍治疗2型糖尿病的疗效和安全性。方法计算机检索中文数据库:中国知网,万方,维普和中国生物医学文献数据库,英文数据库:Pubmed,Embase和Cochrane Library,发表日期截止至2015年6月1日,根据纳入排除标准对文献进行筛选和评价,用Rev-Man 5.3.5软件对数据进行分析。结果1.DPP-4抑制剂+二甲双胍vs.磺脲类药物(SUs)+二甲双胍在降低糖化血红蛋白(Hb A1c)方面两组并无区别;在降低空腹血糖(FPG)方面SUs+二甲双胍优于DPP-4抑制剂+二甲双胍,差异具有统计学意义;在不良反应发生率,低血糖发生率和降低体重方面DPP-4抑制剂+二甲双胍均优于SUs+二甲双胍,差异具有统计学意义。2.DPP-4抑制剂+二甲双胍vs.噻唑烷二酮类药物药物(TZDs)+二甲双胍在降低Hb A1c和FPG方面以及不良反应发生率和低血糖发生率方面两组均没有差别;在降低体重方面DPP-4抑制剂+二甲双胍优于TZDs+二甲双胍,差异具有统计学意义。3.DPP-4抑制剂+二甲双胍vs.GLP-1受体激动剂+二甲双胍在降低Hb A1c,FPG和体重方面,GLP-1受体激动剂+二甲双胍均优于DPP-4抑制剂+二甲双胍,差异具有统计学意义;在不良反应发生率方面DPP-4抑制剂+二甲双胍低于GLP-1抑制剂受体激动剂,差异具有统计学意义;在低血糖发生率方面,两组并无差别。4.DPP-4抑制剂+二甲双胍vs.SGLT-2抑制剂+二甲双胍在降低FPG和体重方面SGLT-2抑制剂+二甲双胍优于DPP-4抑制剂+二甲双胍,差异具有统计学意义;在降低Hb A1c方面和不良反应发生率,低血糖发生率方面,两组并无差别。结论在控制血糖方面,DPP-4抑制剂+二甲双胍疗效仅劣于GLP-1受体激动剂+二甲双胍(P0.05),与其他三种药物与二甲双胍的组合并无差别(P0.05);可以轻微的降低体重;安全性良好,不良反应和低血糖发生率低,可以作为治疗2型糖尿病的一种有效疗法。
[Abstract]:Objective to compare the efficacy and safety of DPP-4 inhibitor metformin and other hypoglycemic drugs metformin in the treatment of type 2 diabetes. Methods Chinese databases were searched by computer: China Zhiwang, Wanfang, Weipu and Chinese Biomedical Literature Database, English Database: Pubmed Embase and Cochrane Library. The publication date was until June 1, 2015. According to the exclusion criteria, the literature was screened and evaluated, and the data were analyzed by Rev-Man 5.3.5 software. Results 1.DPP-4 inhibitor metformin vs. There was no difference between the two groups in reducing HbA1c of glycosylated hemoglobin (HbA1c), SUs metformin was superior to DPP-4 inhibitor metformin in lowering fasting blood glucose, the difference was statistically significant, and the incidence of adverse reactions was higher than that of DPP-4 inhibitor metformin. The incidence of hypoglycemia and weight loss of DPP-4 inhibitor metformin were higher than that of SUs metformin, and the difference was statistically significant. There was no difference between the two groups in reducing HbA1c and FPG, the incidence of adverse reactions and hypoglycemia, and the DPP-4 inhibitor metformin was superior to TZDs metformin in reducing body weight. The difference was statistically significant. 3. Metformin, an agonist of metformin vs.GLP-1 receptor with DPP-4 inhibitor, was superior to DPP-4 inhibitor metformin in reducing HbA1cFPG and body weight, and the difference was statistically significant. The incidence of adverse reactions of DPP-4 inhibitor metformin was significantly lower than that of GLP-1 inhibitor receptor agonist, and the incidence of hypoglycemia was significantly lower than that of GLP-1 inhibitor receptor agonist. There was no difference between the two groups. 4. DPP-4 inhibitor metformin vs.SGLT-2 inhibitor metformin was superior to DPP-4 inhibitor metformin in reducing FPG and body weight, and the difference was statistically significant. There was no difference between the two groups in reducing HB A 1c, adverse reactions and hypoglycemia. Conclusion the effect of metformin, a DPP-4 inhibitor on blood glucose control, is only inferior to that of GLP-1 receptor agonist metformin P0.05, and has no difference with the combination of other three drugs with metformin. Low incidence of adverse reactions and hypoglycemia can be used as an effective treatment for type 2 diabetes.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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