格列齐特和格列吡嗪治疗2型糖尿病的Meta分析

发布时间：2018-05-17 05:29

本文选题：格列齐特 + 格列吡嗪　；参考：《郑州大学》2015年硕士论文

【摘要】：目的:采用Meta分析方法系统评价格列齐特和格列吡嗪治疗2型糖尿病的疗效和安全性,并对格列齐特和格列吡嗪治疗2型糖尿病的成本—效果进行分析,为临床用药合理性经济性提供证据。方法:检索万方数据知识服务平台、维普期刊资源综合服务平台、中华医学会期刊全文数据库、Medline从建库至2014年12月公开发表的关于格列吡嗪与格列齐特在治疗2型糖尿病的随机对照试验。由两名评价员按照纳入标准筛选文献,采用Review Manager 5软件对纳入研究进行Meta分析,并分析合并计算研究的异质性、敏感性及发表偏倚,根据需要选用随机效应模型合并计算。结果:共纳入11篇研究文献,质量等级均为C级。采用Review Manager 5软件Meta分析结果:①格列齐特和格列吡嗪治疗2型糖尿病的总有效率差异无统计学意义[P0.05,OR合并=1.41,95%CI=(0.72,2.75)];敏感性分析分别采用M-H法固定效应模型和随机效应模型与Peto法固定效应模型比较,结果变化微小,显示敏感性低,结果稳定性高;发表偏倚分析所绘漏斗图显示左右基本对称,可以认为发表偏倚可能性小。②格列齐特和格列吡嗪治疗2型糖尿病的显效率差异无统计学意义[P0.05,OR合并=1.01,95%CI=(0.59,1.72)];敏感性分析分别采用M-H法固定效应模型和随机效应模型与Peto法固定效应模型比较,结果基本没有变化,显示敏感性低,结果稳定性高;发表偏倚分析漏斗图左右基本对称,显示发表偏倚可能性很小。③格列齐特和格列吡嗪治疗2型糖尿病的不良反应发生率差异无统计学意义[P0.05,OR合并=1.27,95%CI=(0.62,2.59)];敏感性分析分别采用M-H法固定效应模型和随机效应模型与Peto法固定效应模型比较,结果变化较大,显示敏感性高,结果稳定性低,尚不能认为二者的不良反应发生率无统计学意义;发表偏倚分析所绘漏斗图显示左右基本对称,可以认为发表偏倚可能性小。④格列齐特和格列吡嗪治疗2型糖尿病空腹血糖(FPG)平均降低程度差异无统计学意义[P0.05,OR合并=-0.34,95%CI=(-0.87,0.20)]。⑤格列齐特和格列吡嗪治疗2型糖尿病空腹血糖治疗结果差异有统计学意义[P0.05,OR合并=0.33,95%CI=(0.13,0.52)],格列吡嗪治疗后的空腹血糖水平低于格列齐特,格列吡嗪的疗效优于格列齐特。⑥格列齐特和格列吡嗪治疗2型糖尿病餐后2小时血糖(2h PG)治疗结果差异无统计学意义[P0.05,OR合并=0.04,95%CI=(-0.24,0.32)]。⑦格列齐特和格列吡嗪治疗2型糖尿病糖化血红蛋白结果差异有统计学意义[P0.05,OR合并=0.25,95%CI=(0.05,0.45)],格列吡嗪治疗后的糖化血红蛋白水平低于格列齐特,格列吡嗪的疗效优于格列齐特。⑧对格列齐特和格列吡嗪治疗2型糖尿病进行疗效及治疗费用进行比较,结果显示除了在空腹血糖治疗结果和糖化血红蛋白治疗结果方面,格列吡嗪优于格列齐特外,其它方面疗效基本相似,但是格列吡嗪治疗费用较低。结论:Meta分析结果表明:格列齐特和格列吡嗪治疗2型糖尿病总有效率、显效率、不良反应发生率、空腹血糖平均降低程度、餐后2小时治疗结果等方面差异无统计学意义;在空腹血糖治疗结果和糖化血红蛋白治疗结果方面,格列吡嗪优于格列齐特;药物经济学方面,格列吡嗪较为经济合理。
[Abstract]:Objective: to systematically evaluate the efficacy and safety of gliclazide and glipizide in the treatment of type 2 diabetes by Meta analysis, and to analyze the cost effect of gliclazide and glipizide in the treatment of type 2 diabetes and provide evidence for the rationality and economy of clinical medication. Methods: to retrieve the knowledge service platform of Wanfang Data, and the information of VIP periodicals. The source comprehensive service platform, the full text database of the Chinese Medical Association, Medline from the library to December 2014, published publicly on the randomized controlled trial of glipizide and gliclazide in the treatment of type 2 diabetes. Two evaluators were selected in accordance with the inclusion criteria and used the Review Manager 5 software to carry out Meta analysis of the included studies, and divided them into a study. Analysis of the heterogeneity, sensitivity, and publication bias of the combined calculation, according to the needs of the random effect model combined calculation. Results: a total of 11 research papers were included, the quality grade was C grade. Review Manager 5 software Meta analysis results were used: (1) there was no statistical difference in the total effective difference between glipizide and glipizide treated type 2 diabetes. P0.05, OR combined with =1.41,95%CI= (0.72,2.75)]; the sensitivity analysis was compared with the fixed effect model of M-H method and random effect model and the fixed effect model of Peto method respectively, the result was small, the sensitivity was low, the result was high, and the funnel plot of the publication bias analysis showed that the funnel plot was basically symmetrical, and the possibility of publishing bias was small. There was no significant difference between glicizide and glipizide in the treatment of type 2 diabetes with no significant difference [P0.05, OR combined with =1.01,95%CI= (0.59,1.72)]; sensitivity analysis was compared with the fixed effect model of M-H method and random effect model and Peto fixed effect model, and the results showed that the sensitivity was low and the result was high. The table bias analysis showed that the funnel map was basically symmetrical and showed that the possibility of publication bias was very small. (3) there was no significant difference in the incidence of adverse reactions between gliclazide and glipizide in the treatment of type 2 diabetes, [P0.05, OR combined with =1.27,95%CI= (0.62,2.59)]. The sensitivity analysis was fixed by the M-H fixed effect model and the random effect model and the Peto method, respectively. Compared with the fixed effect model, the results changed greatly, the sensitivity was high and the result was low. The incidence of adverse reactions was not statistically significant in the two cases. The funnel plot of the published bias analysis showed that the left and right symmetry of the left and right sides could be considered. (4) gliclazide and glipizide were used to treat the fasting blood glucose of type 2 diabetes. (FPG) the difference in average reduction was not statistically significant [P0.05, OR combined with =-0.34,95%CI= (-0.87,0.20)]. 5. The difference between glicizide and glipizide in the treatment of type 2 diabetes was statistically significant [P0.05, OR combined with =0.33,95%CI= (0.13,0.52)], and glipizide was lower than glicizine, glipizide, and glipizide The effect of gliclazide and glipizide was better than that of glicizide and glipizide in the treatment of type 2 diabetes after a meal of 2 hours of blood glucose (2H PG), there was no statistical significance [P0.05, OR combined with =0.04,95%CI= (-0.24,0.32)]. 5%CI= (0.05,0.45)), glipizide treated glycosylated hemoglobin levels were lower than glicizide. Glipizide was better than glicizide. The results were compared with glicizide and glipizide in the treatment of type 2 diabetes. The results showed that the results of glycemic hemoglobin and glycated hemoglobin were the result of the treatment. Glipizide was better than gliclazide, and other aspects were similar, but glipizide had a lower cost. Conclusion: Meta analysis showed that gliclazide and glipizide were effective in the treatment of type 2 diabetes, the rate of significant effect, the incidence of adverse reactions, the average decrease in fasting blood glucose, and the difference in the 2 hours after the meal. There is no statistical significance; glipizide is superior to gliclazide in the results of fasting blood glucose treatment and glycosylated hemoglobin, and glipizide is more economical and reasonable in pharmacoeconomics.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

【参考文献】