天麦消渴片对2型糖尿病患者胰岛功能影响的系统评价

发布时间：2018-06-25 06:55

  本文选题：天麦消渴片 + 型糖尿病　； 参考：《中药新药与临床药理》2017年06期

【摘要】：目的系统评价天麦消渴片对2型糖尿病患者胰岛功能指标的影响。方法计算机检索中文全文期刊数据库(CNKI),万方数据库(Wan Fang Data),中国生物医学文献数据库(Sino Med),维普数据库(VIP)、Pub Med、The Cochrane Library以及Embase数据库,纳入有关天麦消渴片对2型糖尿病患者胰岛功能影响的随机对照试验(RCT),检索时限均为建库至2017年9月,由2位研究者独立进行文献筛选、资料提取及纳入研究的质量评价,意见不一致时讨论解决。结果纳入23个随机对照试验(RCT),结局指标包括胰岛素抵抗指数(HOMA-IR)、胰岛β细胞基础分泌指数(HOMA-β)、空腹血浆葡萄糖(FPG)、餐后2 h血糖(2h PPG)以及不良反应。结果显示,在降低HOMA-IR指标方面,天麦消渴片降低胰岛素抵抗指数作用优于安慰剂(SMD=1.61,95%CI[1.20,2.03])P0.00001、噻唑烷二酮类(SMD=0.28,95%CI[0.03,0.53])P=0.03、双胍类(SMD=1.43,95%CI[0.90,1.96])P0.00001、门冬胰岛素(SMD=1.17,95%CI[0.75,1.59])P0.00001。此外,与噻唑烷二酮类(SMD=0.53,95%CI[0.07,0.98])P=0.02、糖苷酶抑制剂(SMD=1.05,95%CI[0.58,1.52])P0.00001、双胍类(SMD=0.49,95%CI[0.28,0.71])P0.00001、磺脲类(SMD=8.57,95%CI[7.27,9.88])P0.00001联用均显示出增效作用;在升高HOMA-β指标方面,天麦消渴片与双胍类(SMD=0.75,95%CI[0.25,1.25])P=0.004、噻唑烷二酮类(SMD=0.59,95%CI[0.01,1.18])P=0.05、磺脲类(SMD=1.53,95%CI[1.08,1.99])P0.00001以及门冬胰岛素(SMD=0.59,95%CI[0.16,1.02])P=0.008联用均显示出增效作用;在降低FPG指标方面,天麦消渴片疗效优于安慰剂(SMD=2.55,95%CI[2.06,3.03])P0.00001,其次,分别与噻唑烷二酮(SMD=1.06,95%CI[0.34,1.79])P=0.004、糖苷酶抑制剂(SMD=0.78,95%CI[0.33,1.24])P=0.0008以及双胍类(SMD=0.56,95%CI[0.43,0.70])P0.00001联用疗效更好;在降低2h PPG指标方面,天麦消渴片疗效优于安慰剂(SMD=1.45,95%CI[1.05,1.85])P0.00001以及门冬胰岛素(SMD=1.43,95%CI[1.00,1.86])P0.00001,其次与噻唑烷二酮(SMD=0.91,9 5%CI[0.47,1.36])P0.0001及双胍类(SMD=0.51,95%CI[0.38,0.64])P0.00001联用疗效更好。此外,天麦消渴片与降糖药物对比安全性较好。结论当前证据表明,天麦消渴片能降低HOMA-IR、FPG以及2h PPG,与部分阳性药物联用可增加疗效,且安全性较好。由于纳入研究普遍存在方法学质量问题,需要开展高质量的研究予以验证。
[Abstract]:Objective to evaluate the effect of Tianmaixiaoke tablets on islet function in type 2 diabetic patients. Methods Chinese full-text periodical database (CNKI), Wan Fang data, Chinese biomedical literature database (Sino Med), VIP database (VIP), Pub Medbin the Cochrane Library and Embase database were searched by computer. A randomized controlled trial (RCT) was conducted on the effects of Tianmaixiaoke tablets on pancreatic islet function in type 2 diabetic patients. The retrieval time was from the establishment of the database to September 2017. The two researchers independently selected the literature, extracted the data and evaluated the quality of the study. Discuss a solution when there is disagreement. Results in 23 randomized controlled trials (RCT), the outcome indexes included insulin resistance index (HOMA-IR), basal secretion index of islet 尾 cells (HOMA- 尾), fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PPG) and adverse reactions. The results showed that Tianmaixiaoke tablet had a better effect on reducing insulin resistance index than placebo (SMD-1.61N95 CI [1.20 卤2.03]) P0.00001, thiazolidone diketone (SMD-0.28995 CI [0.030.53]) P0.03, biguanidine (SMD1.4395CI [0.901.96]) P0.00001, aspartate insulin (SMD1.17995 CI [0.750.59]) P0.00001. the index of insulin resistance in Tianmaixiaoke tablet was better than that in placebo (SMD-1.61N95 CI [1.20 卤2.03]), thiazolidanedione diketone (SMD-0.2895 CI [0.030.53]), biguanidine (SMD-1.4395CI [0.90 卤1.96]). In addition, in combination with thiazolidinediketone (SMD-0.53-95CI [0.070.98]) P0.02, glucosidase inhibitor (SMD-1.0595CI [0.581.52]) P0.00001, biguanidine (SMD-0.49c95 CI [0.280.71]) P0.00001, sulfonylurea (SMD-8.57 / 95CI [7.279.88]) showed synergistic effects; in raising HOMA- 尾, 澶╅害娑堟复鐗囦笌鍙岃儘绫，

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