阿卡波糖与二甲双胍治疗糖尿病前期疗效的Meta分析  

Efficacy of Acarbose and Metformin in Treating Pre- diabetes: A Meta Analysis

作　　者：李琼[1] 李一梅[1] 谢波[1] 韩琳娜[1] 江莲[1] 罗天勇[1] 胡乾配 

机构地区：[1]重庆医科大学附属永川医院全科医学科,重庆市402160

出　　处：《中国全科医学》2015年第3期304-311,共8页Chinese General Practice

摘　　要：目的采用系统评价方法,对比阿卡波糖与二甲双胍治疗糖尿病前期(PD)的效果。方法计算机检索Pub Med、MEDLINE、Cochrane Library、OVID、Elsevier、中国生物医学文献数据库(CBM)、中国知网、维普网、万方数据知识服务平台等数据库,检索时间从建库至2014年2月;手工检索相关杂志、会议论文及未发表的灰色文献等。根据Cochrane系统评价方法,筛选关于阿卡波糖(试验组)对比二甲双胍(对照组)治疗PD的中、英文随机对照试验(RCT),进行纳入文献的资料提取和质量评价,采用Rev Man 5.2软件进行Meta分析。对比试验组与对照组糖尿病发生率、PD控制率、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、体质指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、收缩压(SBP)、舒张压(DBP)、不良反应发生率等指标。结果共纳入18个符合标准的RCT,Meta分析结果显示,试验组糖尿病发生率少于对照组〔危险度(RR)=0.60,95%CI(0.36,1.00),P=0.05〕;试验组PD控制率优于对照组〔RR=1.18,95%CI(1.07,1.30),P=0.001〕;对照组FPG水平低于试验组〔均数差(MD)=-0.05,95%CI(-0.10,0.00),P=0.03〕;试验组2 h PG水平低于对照组〔MD=0.51,95%CI(0.23,0.78),P=0.000 3〕;两组BMI比较,差异无统计学意义〔MD=-0.32,95%CI(-1.04,0.40),P=0.39〕;两组TC水平比较,差异无统计学意义〔MD=-0.04,95%CI(-0.16,0.07),P=0.45〕;对照组TG水平低于试验组〔MD=-0.25,95%CI(-0.48,-0.02),P=0.04〕;对照组SBP和DBP低于试验组〔SBP:MD=-0.95,95%CI(-1.81,-0.09),P=0.03;DBP:MD=-0.97,95%CI(-1.30,-0.64),P<0.000 01〕;两组不良反应发生率比较,差异无统计学意义〔RR=0.68,95%CI(0.41,1.12),P=0.13〕。结论虽然二甲双胍降低FPG、TG及血压的效果优于阿卡波糖,但阿卡波糖在有效控制PD患者2 h PG的同时,能更好地控制糖尿病的发生率,阻止PD向糖尿病发展。Objective To systematically evaluate the efficacy of acarbose and metformin in treating pre - diabetes （PD）. Methods The PubMed,MEDLINE,Cochrane Library,OVID,Elsevier,CBM,CNKI,VIP and Wanfang databases were searched up to February 2014 to collect the English and Chinese literatures about randomized controlled trials（RCT）using acarbose（the experimental group）and metformin（the control group）in treating PD. Relevant journals,conference papers and unpublished literatures were retrieved manually. The reviewers screened the literature,extracted the data and assessed the quality according to the method of Cochrane systematic review,and conducted Meta - analysis with RevMan 5. 2 software. The incidence of diabetes,the control rate of PD,fasting plasma glucose（FPG）,2 - hour postprandial glucose（2 hPG）,body mass index （BMI）,total cholesterol（ TC）,triglycerides（ TG）,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）and adverse events of the experimental group and the control group were compared. Results A total of 18 RCT were included. Meta analysis showed that the experimental group had a lower incidence of diabetes than the control group〔 RR = 0. 60,95% CI （0. 36,1. 00）,P = 0. 05〕;the experimental group had a better PD control rate than the control group〔RR = 1. 18,95% CI （1. 07,1. 30）,P = 0. 001〕;the control group had a lower FPG level than the experimental group〔 MD = - 0. 05,95% CI （ - 0. 10,0. 00）,P = 0. 03〕;the experimental group had a lower 2 hPG than the control group〔MD = 0. 51,95% CI（0. 23, 0. 78）,P = 0. 000 3〕;the BMI of the two groups showed no statistically significant difference〔 MD = - 0. 32,95% CI （ - 1. 04,0. 40）,P = 0. 39〕;the TC of the two groups showed no statistically significant difference〔MD = - 0. 04,95% CI （ - 0. 16,0. 07）,P = 0. 45〕;the control group had a lower TG level than the experimental group〔 MD = - 0. 25,95% CI （ - 0. 48, - 0. 02）,P = 0. 04〕;the control group had lower SBP and DBP

关 键 词：阿卡波糖 二甲双胍 糖尿病前期 META 分析 

分 类 号：R587.1[医药卫生—内分泌]