胃转流术与内科强化治疗2型糖尿病的Meta分析  

Meta-analysis of Roux-en-Y gastric bypass versus intensive lifestyle and medical intervention on type 2 diabetes

作　　者：袁倩[1] 袁慧娟[1] 邓欣如[1] 

机构地区：[1]郑州大学人民医院内分泌科,450003

出　　处：《中国实用医刊》2017年第12期12-16,共5页Chinese Journal of Practical Medicine

摘　　要：目的 探讨胃转流术（RYGB）与内科强化治疗（ILMI）2型糖尿病的疗效差异.方法 检索PubMed、Embase、CNKI、CBM和万方数据库自建库到2016年6月16日,查找胃转流术与内科强化治疗2型糖尿病的随机对照试验（RCT）,由两位研究员独立筛选文献、提取资料和质量评价,采用RevMan 5.3软件进行Meta分析.结果 最终纳入8个RCT,共420例患者,其中205例患者接受胃转流术,215例患者接受内科强化治疗.Meta分析结果显示：与内科治疗相比,胃转流术组空腹血糖下降明显[MD=-2.07,95%CI（-2.93,-1.21）,P＜0.01],糖化血红蛋白降低明显[MD=-1.71,95%CI（-1.86,-1.55）,P＜0.01],糖尿病的缓解率显著提高[RR=6.45,95%CI（3.56,11.68）,P＜0.01],BMI下降明显[MD=-7.23,95%CI（-7.51,-6.94）,P＜0.01],但不良反应发生率增加[RR=1.91,95%CI（1.37,2.66）,P＜0.01].结论 对于2型糖尿病患者,在血糖及体质量控制方面,短期内胃转流术可能优于内科强化治疗,但不良反应的发生率增加.Objective To evaluate the effect of Roux-en-Y gastric bypass（RYGB） versus intensive lifestyle and medical intervention（ILMI） on type 2 diabetes.Methods By searching PubMed, Embase, CNKI, CBM and WANFANG Data base, randomized controlled trials on RYGB versus ILMI for type 2 diabetes were searched. Data extration and quality assessment were done by using the RevMan 5.3 Meta-analysis software.Results Eight RCTs that included a total of 420 patients were included into RYGB group（n=205） and ILMI group（n=215）. The results of Meta-analysis showed that： compared to intensive lifestyle and medical intervention into the RYGB group, fasting plasma glucose[MD=-2.07, 95%CI（-2.93,-1.21）, P〈0.01], glycosylated hemoglobin[MD=-1.71, 95%CI（-1.86,-1.55）, P〈0.01] and BMI[MD=-7.23, 95%CI（-7.51,-6.94）, P〈0.01] decreased more, remission rate of type 2 diabetes[RR=6.45, 95%CI（3.56,11.68）, P〈0.01] increased more. But, the incidence of adverse reactions increased[RR=1.91, 95%CI（1.37,2.66）, P〈0.01].Conclusions For patients with type 2 diabetes, RYGB is superior to ILMI for short-term control of glucose and weight, but increased the incidence of adverse reactions.

关 键 词：2型糖尿病 胃转流术 META分析 

分 类 号：R587.1[医药卫生—内分泌] R656.6[医药卫生—内科学]