241)维格列汀与其他口服降糖药对照治疗2型糖尿病的meta分析占美.doc

维格列汀与其他口服降糖药对照治疗2型糖尿病的Meta-分析 占美，吴逢波，徐珽，黄晶，唐尧（四川大学华西医院药剂科，成都市 610041） [摘要] 目的：系统评价维格列汀治2型糖尿病疗效及安全性。方法：检索Cochrane图书馆，PubMed，EMBASE，CBM，VIP，CNKI数据库。根据Cochrane手册对纳入的随机对照试验（RCT）进行质量评价，并用RevMan5.0软件进行Meta分析。结果：共纳入16个研究，Meta分析结果显示：在降低患者糖化血红蛋白水平方面，维格列汀不及二甲双胍和磺酰脲类[MD=0.25, 95%CI(0.14, 0.37), P0.0001; MD=0.09, 95%CI (0.03, 0.14), P=0.001]；与噻唑烷二酮类及α-糖苷酶抑制剂的疗效相似[MD=0.1, 95%CI (-0.12, 0.32), P=0.39; MD=-0.35, 95%CI (-0.81, 0.11), P=0.13]。在降低体重方面，维格列汀要优于磺酰脲类和噻唑烷二酮类[MD=-1.42, 95%CI(-1.87, -0.97), P0.00001; MD=-1.38, 95%CI(-1.88, -0.87), P0.00001]，但不及二甲双胍和α-糖苷酶抑制剂[MD=1.32, 95%CI(0.52, 2.12), P=0.001; MD=1.30, 95%CI(0.86, 1.74), P0.00001]。维格列汀的不良发应率与噻唑烷二酮相似 [OR=1.09, 95%CI(0.95, 1.25), P=0.23]，低于二甲双胍，磺酰脲类和α-糖苷酶抑制剂组[OR=0.71, 95%CI(0.56, 0.90), P=0.005; OR=0.81, 95%CI(0.67, 0.98), P=0.03; OR=0.55, 95%CI(0.43, 0.72), P0.00001]。维格列汀的低血糖率与二甲双胍，噻唑烷二酮和伏格列波糖相似[OR=0.66, 95%CI(0.39, 1.10), P=0.11；OR=2,15, 95%CI(0.82, 5.64), P=0.12；OR=0.34, 95%CI(0.01, 8.37), P=0.51]；低于磺酰脲类[OR=0.16, 95%CI(0.08, 0.30), P0.00001]。结论：本系统评价结果显示，维格列汀治疗2型糖尿病患者疗效可靠且安全，可以用来治疗2型糖尿病，但远期结果有待进一步研究探讨。 [关键词] 维格列汀；2型糖尿病；Meta分析 [作者简介] 占美，女，在读硕士研究生，以临床药学为主要研究方向，电话028-mail：mandyzhanmei@163.com [通信作者] 唐尧，男，教授，硕士生导师。研究方向：临床药学。电E-mail：HYPERLINK mailto:yaotangwch@yaotangwch@ Vildagliptin Versus Other oral antihyperglycaemia agents in the treatment of type 2 diabetes: a Meta-analysis of Randomized Controlled Trails ZHAN Mei, WU Feng-Bo, XU Ting, HUANG Jing, TANG Yao (Dept. of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China) ABSTRACT: OBJECTIVE To evaluate the efficacy and safety of vildagliptin in people with type 2 diabetes mellitus. METHODS Randomized controlled trials (RCTs) were retrieved from PubMed, EMBASE, the Cochrane Library, CBM，VIP and CNKI . We used the method recommend by the Cochrane Collaboration to perform a Meta-analysis of RCTs. RESULTS 16 studies were included. The Meta-analysis showed that metformin and SUs. provided greater reductions in HbA1c