瑞格列奈联合二甲双胍对比单用瑞格列奈治疗2型糖尿病疗效和安全性的Meta分析  

Meta-analysis on the Efficacy and Safety of Repaglinide Combined with Metformin versus Repaglinide Alone in the Treatment of Type 2 Diabetes

作　　者：卫晋菲[1] 周亮[1] 王心慧[1] 张鑫[1] 王明媚[1] 

机构地区：[1]解放军总医院第一附属医院药剂药理科,北京100048

出　　处：《中国药房》2015年第9期1221-1224,共4页China Pharmacy

基　　金：国家科技支撑计划课题(No.2013BAI06B04)

摘　　要：目的:系统评价瑞格列奈联合二甲双胍对比单用瑞格列奈治疗2型糖尿病的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Medline、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库等,收集瑞格列奈联合二甲双胍(试验组)对比单用瑞格列奈(对照组)治疗2型糖尿病的随机对照试验(RCT),提取数据和评价质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入7项RCT,合计824例患者。Meta分析结果显示,试验组患者糖化血红蛋白[MD=-0.94,95%CI(-1.05,-0.83),P<0.000]、空腹血糖[MD=-1.59,95%CI(-1.77,-1.41),P<0.000]和餐后2 h血糖[MD=-0.93,95%CI(-1.48,-0.38),P<0.000]均显著优于对照组,两组比较差异有统计学意义;试验组患者低血糖发生率[OR=2.40,95%CI(0.89,6.48),P=0.08]和胃肠道反应发生率[OR=0.77,95%CI(0.40,1.50),P=0.44]与对照组比较,差异无统计学意义。结论:瑞格列奈联合二甲双胍治疗2型糖尿病的疗效优于单用瑞格列奈,且安全性相当。由于纳入研究数量较少、质量一般,该结论有待大样本、高质量、长疗程的RCT进一步验证。OBJECTIVE：To systematically evaluate the efficacy and safety of repaglinide combined with metformin versus repaglinide alone in treatment of type 2 diabetes and provide evidence-based reference for the clinic. METHODS：Pub Med,EMBase,Medline,Cochrane Library,CJFD,VIP and Wanfang database were retrieved to collect randomized controlled trail（RCT）about repaglinide combined with metformin（trial group）and repaglinide alone（control group）in treatment of type 2 diabetes. Meta-analysis was performed by Rev Man 5.2 software after data extraction and quality evaluation. RESULTS：A total of 7 RCT were included,involving 824 patients. Meta-analysis showed that Hb A1c[MD=-0.94,95%CI（-1.05,-0.83）,P〈0.000],FPG[MD=-1.59,95%CI（-1.77,-1.41）,P〈0.000] and 2 h PG[MD=-0.93,95% CI（-1.48,-0.38）,P〈0.000] in trial group were significantly better than that of control group,there was significant difference. There were no significant difference in the incidence of hypoglycemia [OR=2.40,95% CI（0.89,6.48）,P=0.08] and gastrointestinal disorders [OR=0.77,95% CI（0.40,1.50）,P=0.44] in trial group. CONCLUSIONS：Repaglinide combined with metformin in treatment of type 2 diabetes is more effective than repaglinide alone with similar safety. Due to the small number and general quality of included studies,it remains to be further verified by largesample and high-quality RCT.

关 键 词：瑞格列奈 二甲双胍 2型糖尿病 META分析 随机对照试验 疗效 安全性 

分 类 号：R977.95[医药卫生—药品] R969.4[医药卫生—药学]