α-硫辛酸治疗糖尿病胃轻瘫的Meta分析

发布时间：2018-05-09 00:13

  本文选题：α-硫辛酸 + 糖尿病　； 参考：《河北医科大学》2017年硕士论文

【摘要】：目的:系统评价α-硫辛酸治疗糖尿病胃轻瘫患者的临床疗效,分析该药物治疗后的各项症状改善及不良反应事件发生情况,为临床应用提供依据。方法:1检索Medline、Pubmed、Embase、Cochrane中国知网、万方和维普等数据库,收集近5年(2011.01.01—2016.12.31)有关α-硫辛酸治疗糖尿病胃轻瘫的临床研究文献。2应用Rev.Man 5软件,对于α-硫辛酸治疗糖尿病胃轻瘫的临床疗效(总有效率,胃排空时间、胃排空率,上腹饱胀、嗳气、恶心/呕吐、食欲不振等症状)及血清胃动素和胃泌素水平变化进行Meta分析。对于计量资料选用均数差值(Mean difference,MD)作为效应量。对于计数资料选用比值比(Odd Risk,OR)作为效应量。结果:1共获得符合标准的研究10项,共纳入研究对象762例(试验组386例,对照组376例),其中涉及总有效率10篇,胃排空时间2篇,胃排空率4篇,上腹饱胀2篇,嗳气2篇,恶心/呕吐2篇,食欲不振2篇,血清胃动素4篇,血清胃泌素水平3篇,不良反应6篇;2 Meta分析结果显示:(1)在总有效率(OR=3.76,95%CI=2.54~5.57)、胃排空时间(MD=-1.40,95%CI=-1.88~-0.91)、胃排空率(MD=13.37,95%CI=10.18~16.55)、嗳气(MD=-0.23,95%CI=-0.35~-0.11)、食欲不振(MD=-0.37,95%CI=-0.52~-0.22)等方面疗效明显优于对照组;(2)血清胃动素(MD=-125.42,95%CI=-138.79~-122.05)、血清胃泌素(MD=-18.97,95%CI=-26.96~-10.98)水平与对照组比较有明显差异;(3)在发生不良反应事件的比例(OR=1.82,95%CI=0.74~4.48)、上腹饱胀(MD=-0.26,95%CI=-0.56~0.04)和恶心/呕吐(MD=-0.11,95%CI=-0.44~0.22)等指标方面与对照组无明显差异。结论:1α-硫辛酸联合促动力药治疗糖尿病胃轻瘫具有显著的临床疗效,可明显提高DGP患者的胃排空率,缩短胃排空时间,显著改善患者嗳气、食欲不振等症状;疗效明显优于单独应用促动力药物。2α-硫辛酸可明显增强促动力药物治疗DGP的临床疗效,可能与其通过抗氧化应激损伤,发挥对胃肠神经及胃Cajal间质细胞、平滑肌细胞的保护功能,同时改善胃肠激素分泌紊乱,进而改善胃动力,促进胃排空有关。3α-硫辛酸治疗糖尿病胃轻瘫,有良好安全性。4由于本研究纳入的文献质量和数量所限,以上结论仍需开展更多大样本、多中心、设计严格的随机双盲对照研究进一步验证。
[Abstract]:Objective: to evaluate the clinical efficacy of 伪 -lipoic acid in the treatment of diabetic gastroparesis, and to analyze the improvement of symptoms and the occurrence of adverse events after the treatment, so as to provide the basis for clinical application. Methods Rev.Man 5 software was used to search the database of Medlinea Pubmedus Embase Cochrane Cochrane, Wanfang and Wiper in the past 5 years. The clinical literatures of 伪 -lipoic acid on the treatment of diabetic gastroparesis were collected from January 1, 2011 to June 12, 31. 1) the clinical literature of 伪 -lipoic acid in the treatment of diabetic gastroparesis was analyzed by Rev.Man 5 software. Clinical efficacy of 伪 -lipoic acid in the treatment of diabetic gastroparesis (total effective rate, gastric emptying time, gastric emptying rate, upper abdominal fullness, belching, nausea / vomiting, Changes of serum motilin and gastrin levels were analyzed by Meta. For the measurement data, the mean difference (mean difference) is chosen as the effect quantity. For the counting data, the ratio ratio of Odd Riskor was chosen as the effect quantity. Results A total of 10 studies were carried out according to the criteria. 762 subjects (386 in the experimental group and 376 in the control group) were included in the study. The total effective rate was 10, gastric emptying time was 2, gastric emptying rate was 4, upper abdominal fullness was 2, belching was 2. Nausea / vomiting 2, loss of appetite 2, serum motilin 4, serum gastrin 3, nausea / vomiting 2, anorexia 2, serum motilin 4, serum gastrin 3. 涓嶈壇鍙嶅簲6绡，

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