参芪降糖剂联合二肽基肽酶IV抑制剂治疗2型糖尿病meta分析  

Meta-analysis of Shenqi Jiangtang Agent combined with dipeptidy l peptidase 4 inhibitors for type 2 diabetes mellitus

作　　者：谭丽 冯兴中 高慧娟[2] 唐铭 李龙朝 李婷婷 Tan Li;Feng Xingzhong;Gao Huijuan;Tang Ming;Li Longchao;Li Tingting(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Tsinghua University Yuquan Hospital;Beijing Shijitan Hospital,Capital Medical University;Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]清华大学玉泉医院 [3]首都医科大学附属北京世纪坛医院 [4]北京中医药大学

出　　处：《现代中医临床》2021年第5期57-64,共8页Modern Chinese Clinical Medicine

基　　金：北京市医院管理局重点医学专业--中医糖尿病(No.ZYLX201812);2019年重大疑难疾病中西医临床协作能力建设项目(No.国中医药办医政发〔2018〕3号)。

摘　　要：目的系统评价参芪降糖剂联合二肽基肽酶IV(dipeptidy l peptidase 4,DPP-4)抑制剂治疗2型糖尿病有效性和安全性。方法计算机检索中国知网(CNKI)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库(Wan Fang),PubMed,Embase,Cochrane Library等数据库,收集参芪降糖剂联合DPP-4抑制剂治疗2型糖尿病的随机对照试验研究(randomized controlled trial,RCT)。由2名研究者根据纳入排除标准、Cochrane偏倚风险评估工具独立进行文献筛选、方法学质量评价,采用RevMan 5.3软件对纳入研究进行数据分析。结果共纳入8个RCT研究,共843例患者,其中治疗组422例患者,对照组421例患者。治疗组总有效率优于对照组(RR=1.19,95%CI[1.09,1.30],P<0.0001);治疗组降低空腹血糖疗效优于对照组(MD=-1.62,95%CI[-1.80,-1.44],P<0.00001);治疗组降低餐后2 h血糖的疗效优于对照组(WMD=-1.01,95%CI[-1.15,-0.86],P<0.00001);治疗组降低HbA1c的疗效优于DPP-4抑制剂组,差异有统计学意义(MD=-1.23,95%CI[-1.41,-1.04],P<0.00001);治疗组胰岛素抵抗指数降低优于对照组(MD=-0.79,95%CI[-0.87,-0.71],P<0.00001);治疗组胰岛β细胞功能指数改善优于对照组(MD=12.45,95%CI[11.31,13.59],P<0.00001);治疗组IL-6下降程度优于对照组(MD=-9.60,95%CI[-10.21,-9.00],P<0.00001);治疗组不良反应发生率明显低于对照组(RR=0.32,95%CI[0.17,0.58],P=0.0002<0.05)。结论参芪降糖剂联合DPP-4抑制剂治疗2型糖尿病疗效优于DPP-4抑制剂组,不良反应发生率明显低于DPP-4抑制剂组。后期需更多高质量、大样本、多中心RCT,验证参芪降糖剂联合DPP-4抑制剂治疗2型糖尿病的临床疗效和安全性。Objective To systemically evaluate the validity and safety of Shenqi Jiangtang Agent combined with dipeptidy l peptidase 4 inhibitors for type 2 diabetes mellitus.Methods Randomized controlled trials(RCT)of Shenqi Jiangtang Agent combined with DPP-4 inhibitors for the treatment of type 2 diabetes mellitus were collected from China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP),China Biomedical Literature Database(CBM),Wan Fang Database(Wan Fang),PubMed,Embase,Cochrane Library and other databases.According to the inclusion and exclusion criteria and the Cochrane bias risk assessment tool,two researchers independently conducted literature screening and methodological quality evaluation.RevMan 5.3 software was used to analyze the data of the included studies.Results A total of 8 RCT studies were included with a total of 843 patients,including 422 patients in the Shenqi Jiangtang Agent combined with DPP-4 inhibitors group(treatment group)and 421 patients in the DPP-4 inhibitors group(control group).The total effective rate was better in the treatment group than in the control group(RR=1.19,95%CI[1.09,1.30],P<0.0001);the treatment group had a better efficacy in reducing fasting blood glucose than the control group(MD=-1.62,95%CI[-1.80,-1.44],P<0.00001);the effect of reducing blood glucose 2 hours after a meal was better in the treatment group than in the control group(WMD=-1.01,95%CI[-1.15,-0.86],P<0.00001);the efficacy of HbA1c was more significantly reduced in the treatment group than in the control group(MD=-1.23,95%CI[-1.41,-1.04],P<0.00001);the treatment group had better insulin resistance index reduction than the control group(MD=-0.79,95%CI[-0.87,-0.71],P<0.00001).The improvement of pancreaticβ-cell function index was better in the treatment group than in the control group(MD=12.45,95%CI[11.31,13.59],P<0.00001).The decrease of IL-6 was better in the treatment group than in the control group(MD=-9.60,95%CI[-10.21,-9.00],P<0.00001).The incidence of adverse reactions

关 键 词：参芪降糖剂 二肽基肽酶IV抑制剂 2型糖尿病 随机对照试验 META分析 

分 类 号：R255.4[医药卫生—中医内科学]