吡格列酮联合二甲双胍治疗2型糖尿病效果meta研究.doc

吡格列酮联合二甲双胍治疗2型糖尿病效果meta研究 　　摘 要 目的：系统评价吡格列酮联合二甲双胍治疗2型糖尿病的疗效和安全性。方法：检索Cochrane Library、PubMed、EMbase、CBM、CNKI、VIP、WanFang Data共7个数据库，收集主题为吡格列酮联合二甲双胍治疗2型糖尿病的文献；根据排除标准筛选确定最终文献，并根据Cochrane手册评价纳入研究质量，最后提取结局指标数据运用RevMan 5.2进行meta分析。结果：纳入15篇文献，包含T2DM患者1 881例，其中联合组941例，二甲双胍单用组940例。结果显示，联合组更能有效降低血糖和糖化血红蛋白，改善胰岛素及血脂，但体质指数无显著差异；不良反应方面，两组在胃肠道事件发生率方面无显著差异；但联合组的水肿发生率略高于单用组。结论：联合用药效果优于二甲双胍单用，且安全性良好。 关键词 2 型糖尿病 吡格列酮 二甲双胍 meta分析 中图分类号：R977.15 文献标识码：A 文章编号：1006-1533（2014）07-0029-08 Meta-analysis of the effectiveness of pioglitazone combined with metformin in the treatment of type 2 diabetes mellitus LIU Qin*， LI Qing， LI Mengzhen， SHI Liwen， ZHANG Tingting， QIU Jiaxue** （School of International Pharmaceutical Business， China Pharmaceutical University， Nanjing 211198， China） ABSTRACT Objective： The effectiveness and safety of pioglitazone combined with metformin in the treatment of type 2 diabetes mellitus （T2DM） were systematically reviewed. Methods： The related literatures were searched and collected from 7 databases including Cochrane Library， PubMed， EMbase， CBM， CNKI， VIP， WanFang Data. The final literatures were selected based on inclusion and exclusion criteria. Their quality was evaluated according to the Cochrane Collaborations tool for assessing risk of bias in randomized controlled trials and the data were measured using RevMan 5.2 software. Results： Fifteen studies were included involving in a total of 1 881 cases with T2DM （941 cases in combination therapy group and 940 in metformin mono-therapy group）. Meta-analysis results showed that the levels for blood glucose， HbA1c， insulin and HDL-C were more effectively improved in the combination therapy group， however， there were no significant differences in BMI as well as the incidence of gastrointestinal events. The incidence of edema is a little bit higher in combination therapy group than in mono-therapy group. Conclusion： The combination therapy of pioglitazone and metformin showed a better efficiency