那格列奈与瑞格列奈治疗2型糖尿病疗效与安全性的Meta分析  

Efficacy and Safety of Nateglinide and Repaglinide in the Treatment of Type 2 Diabetes:a Meta-analysis

作　　者：袁红宇[1] 张伟中[1] 郭玉娇[1] 孟玲[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029

出　　处：《中国药房》2012年第44期4196-4200,共5页China Pharmacy

摘　　要：目的:系统评价那格列奈与瑞格列奈治疗2型糖尿病的疗效和安全性。方法:计算机检索Pubmed、EMbase、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普数据库、万方数据库中那格列奈和瑞格列奈治疗2型糖尿病的随机对照试验(RCT)的相关文献,采用RevMan5.0软件进行统计分析。结果:共有23项RCT,合计2402例患者满足纳入标准。Meta分析结果显示,2组空腹血糖值(FBG)[MD=-0.31,95%CI(-0.70,0.08),P=0.12]、餐后2h血糖(2hPBG)下降差值[MD=-0.08,95%CI(-0.31,0.15),P=0.49]、不良反应发生率[OR=0.92,95%CI(0.68,1.24),P=0.57]比较差异均无统计学意义;糖化血红蛋白(HbA1c)下降差值比较差异有统计学意义,瑞格列奈组明显优于那格列奈组[MD=-0.14,95%CI(-0.26,-0.02),P=0.03]。但国内、外比较结论有差异。结论:那格列奈与瑞格列奈降低FBG和2hPBG疗效相当,瑞格列奈降低HbA1c疗效优于那格列奈,二者的不良反应发生率无统计学差异。国内、外结论有差异,提示二药治疗效果可能与人种差异有关。OBJECTIVE：To evaluate the efficacy and safety of nateglinide and repaglinide in the treatment of type 2 diabetes.METHODS：Randomized controlled trials（RCTs） about nateglinide and repaglinide for type 2 diabetes were retrieved from Pubmed,EMbase,CNKI,CBM,VIP database and Wanfang database.Meta-analysis were conducted by Rev Man 5.0 software.RESULTS：23 RCT including 2 402 patients met the inclusion criteria.Results of Meta-analysis showed that FBG [MD=-0.31,95%CI（-0.70,0.08）,P=0.12],the decrease of 2 h postprandial PBG [MD=-0.08,95%CI（-0.31,0.15）,P=0.49],the incidence of ADR [OR=0.92,95%CI（0.68,1.24）,P=0.57] had no statistical significance;there was statistical significance in the difference of HbA1c decrease,and that of repaglinide group was better than nateglinide group [MD=-0.14,95%CI（-0.26,-0.02）,P=0.03].But domestic conclusion was different from foreign one.CONCLUSION：Nateglinide and repaglinide have the similar effect on reducing FBG and 2 h PBG,but repaglinide has certain superiority on reducing HbA1c.There is no statistical difference in the incidence of adverse drug reactions.The difference of domestic conclusion with foreign one indicates that therapeutic efficacy of them may be associated with ethnic group.

关 键 词：那格列奈 瑞格列奈 2型糖尿病 META分析 

分 类 号：R969.4[医药卫生—药理学]