不同营养治疗方式对成人糖尿病前期患者有效性的网状Meta分析  

作　　者：苏文浩 贾海荣 张佳琪 魏朝阳 邵苡纯 于深奥 杨倮 王彦茹 

机构地区：[1]浙江中医药大学,310053

出　　处：《浙江临床医学》2025年第3期412-415,418,共5页Zhejiang Clinical Medical Journal

摘　　要：目的通过网状Meta分析比较面对面、远程、混合医学营养治疗和标准治疗对糖尿病前期患者的有效性。方法检索Medline,Embase,Cochrane,PubMed和Web of Science数据库中关于面对面、远程、混合医学营养治疗和标准治疗对糖尿病前期治疗有效性的文献,检索时间为1995年1月1日至2024年8月16日。由2名研究者独立筛选文献、资料提取和质量评价,并采用Revman Manager 5.3、R 3.5.1和STATA 16.0软件进行统计分析。结果共纳入20项研究,涉及5,833例患者。关于BMI,混合医学营养治疗(SMD:-1.93,95%CI:-3.25~-0.58;SUCRA值84.9%)和面对面医学营养治疗(SMD:-1.02,95%CI:-2.04~-0.01;SUCRA值14%)优于标准治疗。混合医学营养治疗在降低空腹血糖(SMD:-5.41,95%CI:-10.03~-0.78;SUCRA值58.7%)、体质量(SMD:-4.2,95%CI:-6.57~-1.87;SUCRA值81.8%)和腰围(SMD:-3.6,95%CI:-5.27~-1.79;SUCRA值73.4%)方面表现出最佳疗效。结论4种方式治疗糖尿病前期均有一定疗效。其中混合医学营养治疗在降低空腹血糖、体质量和腰围方面疗效最好。但研究结果存在较大异质性,仍需进一步开展高质量研究验证。Objective To compare the effectiveness of face-to-face,remote,mixed medical nutrition therapy and standard treatment for adults with pre diabetes through network Meta-analysis.Methods The literature on the effectiveness of face-to-face,remote,mixed medical nutrition treatment and standard treatment for the treatment of diabetes in the Medline,Embase,Cochrane,PubMed and Web of Science databases were retrieved from January 1,1995 to August 16,2024.Two researchers independently screened literature,extracted data,and evaluated quality,and conducted statistical analysis using Revman Manager 5.3,R 3.5.1,and STATA 16.0 software.Results A total of 20 studies were included,involving 5833 participants.Regarding body mass index(BMI),mixed medical nutrition therapy(SMD:-1.93,95%CI:-3.25,-0.58;SUCRA value 84.9%)and face-to-face medical nutrition therapy(SMD:-1.02,95%CI:-2.04,-0.01;SUCRA value 14%)were superior to standard treatment.Mixed medical nutrition therapy showed the best efficacy in reducing fasting blood glucose(SMD:-5.41,95%CI:-10.03~-0.78;SUCRA value 58.7%),body weight(SMD:-4.2,95%CI:-6.57~-1.87;SUCRA value 81.8%),and waist circumference(SMD:-3.6,95%CI:-5.27~-1.79;SUCRA value 73.4%).Conclusion The four treatment methods have certain effects on pre diabetes.Among them,mixed medical nutrition therapy has the best therapeutic effect in reducing fasting blood glucose,weight,and waist circumference.However,there is significant heterogeneity in the research results,and further high-quality research verification is needed.

关 键 词：面对面医学营养治疗 远程医学营养治疗 糖尿病前期 网状Meta分析 

分 类 号：R587.1[医药卫生—内分泌]