sglt2抑制剂联合二甲双胍治疗二型糖尿病的Meta分析  

Meta-analysis of sglt2 Inhibitor Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus

作　　者：付林杰 苏海玉 李海志 FU Linjie;SU Haiyu;LI Haizhi(Department of Pharmacy,Fuwai Yunnan Hospital,Chinese Academy of Medical Sciences/Affilated Cardiovascular Hospital of Kunming Medical University,Kunming 650102,Yunnan,China;School of Pharmacy,Kunming Medical University,Kunming 650500,Yunnan,China)

机构地区：[1]云南省阜外心血管病医院/昆明医科大学附属心血管病医院药剂科,云南昆明650102 [2]昆明医科大学药学院,云南昆明650500

出　　处：《医学信息》2025年第1期49-54,共6页Journal of Medical Information

基　　金：云南省教育厅科学研究基金项目(编号:2025J0314);云南省科技厅科技计划项目(编号:202103AC100004、202302AA310045)。

摘　　要：目的系统评价在单一药物治疗二型糖尿病(T2DM)疗效不佳的情况下使用钠-葡萄糖协同转运蛋白2(sglt2)抑制剂和二甲双胍联合治疗的有效性,为临床用药提供循证参考。方法计算机检索PubMed、Embase、Medline、CBM、中国知网(CNKI)、维普(VIP)、万方(Wangfang data)数据库有关sglt2抑制剂联合二甲双胍(观察组)对比其他任意两种药物(对照组)治疗T2DM疗效的文献,检索时间从建库至2022年12月31日。采用RevMan5.3软件进行Meta分析,漏斗图进行偏倚分析。结果最终纳入17篇文献,共3431例患者,Meta分析结果显示,观察组空腹血糖值(MD=-0.48,95%CI=-0.76~-0.19,P=0.001)、餐后2 h血糖值(MD=-0.41,95%CI=-0.67~-0.14,P=0.003)、糖化血红蛋白值(MD=-0.53,95%CI=-0.78~-0.28,P<0.00001)优于对照组。结论sglt2抑制剂联用二甲双胍在单一药物治疗不佳的情况下治疗T2DM效果理想,且均未发生严重不良反应。Objective To systematically evaluate the efficacy of sodium-glucose cotransporter 2(sglt2)inhibitors combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)with poor efficacy of single drug,and to provide evidence-based reference for clinical medication.Methods PubMed,Embase,Medline,CBM,China National Knowledge Infrastructure(CNKI),VIP and Wangfang data databases were searched by computer for the literature on the efficacy of sglt2 inhibitor combined with metformin(observation group)compared with any other two drugs(control group)in the treatment of T2DM from the establishment of the database to December 31,2022.Meta-analysis was performed using RevMan5.3 software,and funnel plot was used for bias analysis.Results A total of 17 articles were included,involving 3431 patients.The results of meta-analysis showed that the fasting blood glucose(MD=-0.48,95%CI=-0.76 to-0.19,P=0.001),2 h postprandial blood glucose(MD=-0.41,95%CI=-0.67 to-0.14,P=0.003)and glycosylated hemoglobin(MD=-0.53,95%CI=-0.78 to-0.28,P<0.00001)in the observation group were better than those in the control group.Conclusion sglt2 inhibitor combined with metformin is effective in the treatment of T2DM with poor single drug treatment,and no serious adverse reactions occur.

关 键 词：sglt2抑制剂 二甲双胍 T2DM 

分 类 号：R587.1[医药卫生—内分泌]