阿卡波糖治疗糖耐量损伤疗效的系统评价  

Systematic Review of the Efficacy of Acarbose Treatment in Impaired Glucose Tolerance

作　　者：柴丽青[1] 阎爱荣[1] 

机构地区：[1]山西省人民医院药学部,太原030012

出　　处：《中国药房》2015年第18期2509-2512,共4页China Pharmacy

基　　金：国家科技支撑计划课题(No.2013BAI06B04)

摘　　要：目的:系统评价阿卡波糖治疗糖耐量损伤(IGT)的疗效,以为临床治疗提供循证参考。方法:计算机检索Medline、Cochrane图书馆、Pub Med、EMBase、维普数据库、中国期刊全文数据库、万方数据库,收集阿卡波糖(试验组)对比安慰剂(对照组)治疗IGT的随机对照试验(RCT),提取资料并评价质量后,采用Rev Man 5.0统计软件进行Meta分析。结果:共纳入26项RCT,合计2 221例患者。Meta分析结果显示,试验组患者空腹血糖水平[WMD=-0.76,95%CI(-0.99,-0.53),P<0.001]、餐后2 h血糖水平[WMD=-1.58,95%CI(-1.82,-1.34),P<0.001]、糖化血红蛋白水平[WMD=-0.46,95%CI(-0.82,-0.11),P=0.01]、体质量指数[WMD=-1.10,95%CI(-1.77,-0.44),P=0.001]、总胆固醇水平[WMD=-0.35,95%CI(-0.59,-0.12),P=0.003]、甘油三酯水平[WMD=-0.30,95%CI(-0.44,-0.16),P<0.001]均显著低于对照组,而高密度脂蛋白水平[WMD=-0.05,95%CI(-0.11,0.01),P=0.11]和低密度脂蛋白水平[WMD=-0.13,95%CI(-0.31,0.05),P=0.17]与对照组比较差异无统计学意义。结论:阿卡波糖治疗IGT疗效较好。由于纳入研究质量不高,该结论有待大样本、高质量的RCT进一步验证。OBJECTIVE：To evaluate the efficacy of acarbose treatment in impaired glucose tolerance（IGT）and provide evidence-based reference for the clinical treatment. METHODS：Medline,Cochrane library,Pub Med,EMBase,VIP database,CJFD and Wanfang database were retrieved to collect the randomized controlled trials（RCT）of comparison treatment（test group）of acarbose and placebo（control group）in IGT. After the information collection and quality evaluation,Rev Man 5.0 was conducted for Mata-analysis. RESULTS：26 RCT,involving 2 221 patients were include in total. Meta-analysis result showed,compared with placebo,acarbose could reduce FPG[WMD=-0.76,95%CI（-0.99,-0.53）,P〈0.001],2 h PG[WMD=-1.58,95%CI（-1.82,-1.34）,P〈0.001],Hb A1c[WMD=-0.46,95%CI（-0.82,-0.11）,P=0.01],BMI[WMD=-1.10,95%CI（-1.77,-0.44）,P=0.001],TC[WMD=-0.35,95% CI（-0.59,-0.12）,P=0.003],TG[WMD=-0.30,95% CI（-0.44,-0.16）,P〈0.001] significantly;it had no significant difference on HDL-C[WMD=-0.05,95%CI（-0.11,0.01）,P=0.11] and LDL-C[WMD=-0.13,95%CI（-0.31,0.05）,P=0.17]. CONCLUSIONS：Acarbose has better efficacy in the treatment of IGT. Due to the low quality of included studies,it remains to be further verified by RCT with large sample and high quality.

关 键 词：阿卡波糖 糖耐量损伤 META分析 疗效 

分 类 号：R587.1[医药卫生—内分泌]