西格列汀联合二甲双胍治疗2型糖尿病的meta分析  

Effects of sitagliptin combined with metformin for type 2 diabetes mellitus:a meta-analysis

作　　者：初菁菁 徐哲荣[2] 丁丞[1] 沈毅[1] 

机构地区：[1]浙江大学公共卫生学院流行病与卫生统计学教研室,杭州310058 [2]浙江大学医学院附属第一医院老年病科,杭州310003

出　　处：《上海交通大学学报（医学版）》2013年第11期1501-1508,共8页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的系统评价西格列汀(SITA)联合二甲双胍(MET)治疗2型糖尿病(T2DM)的疗效及不良反应。方法计算机检索Cochrane图书馆、PubMed、EMbase、中国知网、万方数据库和维普数据库,查找国内外所有比较SITA联合MET与MET单独用药治疗T2DM的随机对照试验,使用Cochrane协作网RevMan 5.2软件进行meta分析。结果共纳入12个随机对照试验,合计3 200例患者。Meta分析结果显示:SITA联合MET治疗较单用MET能有效降低糖化血红蛋白水平[WMD=-0.69%,95%CI(-0.85,-0.53),P<0.000 01]、空腹血糖水平[WMD=-0.91%,95%CI(-1.14,-0.69),P<0.000 01],同时改善胰岛素抵抗[WMD=-0.54,95%CI(-0.99,-0.10),P=0.02];在体质量指数变化、不良反应发生率方面,两组差异无统计学意义(P>0.05)。结论 SITA联合MET治疗T2DM安全有效,较单用MET能更有效地控制血糖,两者不良反应发生率差异无统计学意义。Objective To assess the effects and safety of sitagliptin （SITA） combined with metformin （MET） in treating type 2 diabetes mellitus （T2DM）. Methods The Cochrane Library, PubMed, EMbase, CNKI Database, WangFang Database, and VIP Database were searched to collect the randomized controlled trials （RCTs） on SITA combined with MET versus MET in treating T2DM. meta-analysis was performed using RevMan 5.2 software in accordance with the Cochrane Collaboration. Results A total of 12 RCTs involving 3 200 patients were included. The results of meta-analysis showed that, compared to MET alone, SITA combined with MET effectively improved glycosylated hemoglobin levels [ WMD = -0.69%,95%CI （ -0.85, -0.53）, P 〈0.000 01] and fasting plasma glucose levels [ WMD = -0.91%,95% C1 （ -1.14, - 0. 69）, P 〈 0.000 01], and increased insulin sensitivity and i3-cell function [ WMD = - 0. 54, 95% CI （ -0.99, -0. 10）, P = 0.02]. But there were no significant differences between the two groups in body mass index and the percentage of patients with adverse events （P 〉 0.05）. Conclusion Compared to using MET alone, SITA combined with MET can improve glycemic control, and there is no statistical difference of adverse events.

关 键 词：西格列汀 二甲双胍 2型糖尿病 META分析 

分 类 号：R587.1[医药卫生—内分泌]