SGLT-2抑制剂联合二甲双胍、DPP-4抑制剂治疗2型糖尿病疗效和安全性的Meta分析

发布时间：2018-05-24 03:36

本文选题：钠-葡萄糖转运体 + 二甲双胍　；参考：《中国新药与临床杂志》2017年12期

【摘要】：目的系统评价钠-葡萄糖转运蛋白2(SGLT-2)抑制剂联合二甲双胍和二肽基肽酶-4(DPP-4)抑制剂治疗2型糖尿病(T2DM)的疗效和安全性。方法计算机检索Cochrane Library、Medline、Embase、相关期刊论文、维普数据库、万方数据资源系统、中国生物医学文献数据库,检索时限为建库至2017年3月,收集SGLT-2抑制剂联合二甲双胍、DPP-4抑制剂治疗T2DM的随机对照试验。由两名评价员独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入8个随机对照临床试验,总共3 035例患者。Meta分析结果显示:SGLT-2抑制剂联合二甲双胍、DPP-4抑制剂组较二甲双胍联合DPP-4抑制剂组能更有效改善糖化血红蛋白、空腹血糖、餐后血糖、体重、血压,均有显著差异(P0.05),但生殖系统感染发生风险高于对照组[RR=4.39,95%CI(2.63,7.33),P0.000 01],而不良事件、低血糖、泌尿系感染和骨折发生风险方面两组比较均无显著差异(P0.05)。结论 SGLT-2抑制剂联合二甲双胍、DPP-4抑制剂较二甲双胍联合DPP-4抑制剂能更有效控制血糖、体重和血压,但生殖系统感染发生风险增加,其他安全性指标无差异。
[Abstract]:Objective to evaluate the efficacy and safety of sodium glucose transporter (SGLT-2) inhibitor combined with metformin and dipeptidyl peptidase (dipeptidyl peptidase) inhibitor in the treatment of type 2 diabetes mellitus (T2DM). Methods Cochrane Library MedlineEmbase, full text Database of Chinese Journals, Weip Database, Wanfang data Resource system, Chinese Biomedical Literature Database were searched by computer. A randomized controlled trial of SGLT-2 inhibitor combined with metformin DPP-4 inhibitor in the treatment of T2DM was conducted. After two evaluators independently sifted the literature, extracted the data and evaluated the methodological quality of the study, the Meta analysis was carried out with Rev Man 5.3 software. Results A total of 3 035 patients were enrolled in 8 randomized controlled clinical trials. The results of meta-analysis showed that the concentration of 1% SGLT-2 inhibitor combined with metformin DPP-4 inhibitor group was more effective than that of metformin combined with DPP-4 inhibitor group in improving glycosylated hemoglobin and fasting blood glucose. There were significant differences in postprandial blood glucose, body weight and blood pressure, but the risk of reproductive system infection was higher than that of the control group [RRN 4.39 卤95CII 2.63 7.33 P 0.000 01], but there was no significant difference in adverse events, hypoglycemia, urinary tract infection and fracture risk between the two groups (P 0.05). Conclusion SGLT-2 inhibitor combined with metformin DPP-4 inhibitor is more effective than metformin combined with DPP-4 inhibitor in controlling blood glucose, body weight and blood pressure, but the risk of reproductive system infection is increased, but there is no difference in other safety indexes.
【作者单位】：湖南师范大学第一附属医院药学部;湖南师范大学药学系;湖南航天医院药剂科;
【分类号】：R587.1

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