CAJ | 학술논문

目的:探讨比较瑞格列奈联合二甲双胍与那格列奈联合二甲双胍治疗2型糖尿病的疗效和安全性.方法:检索PubMed、Medline、Cochrane图书馆、EMbase、VIP、CNKI、万方数据库,按照Cochrane Handbook 5.1.0评价系统评价方法,查找瑞格列奈联合二甲双胍和那格列奈联合二甲双胍治疗2型糖尿病的随机对照试验(RCT),进行数据提取和质量评价后,采用RevMan 5.2软件进行Meta分析.结果:共纳入5篇RCT文献,437例患者.Meta分析结果显示:在降低患者糖化血红蛋白[MD = – 0.61,95%CI(– 0.64,– 0.58),P < 0.00001]方面,瑞格列奈联合二甲双胍组优于那格列奈联合二甲双胍组;在降低空腹血糖[MD = – 0.46,95%CI(– 0.97,0.05),P = 0.08]和餐后2小时血糖[MD = 0.29,95%CI(– 0.92,1.50),P = 0.64]方面,两组没有统计学差异;在低血糖反应发生率[OR = 1.25,95%CI(0.34,4.58),P = 0.74]和胃肠道反应发生率[OR = 1.02, 95%CI(0.31,3.32),P = 0.98]方面,两组的差异没有统计学意义.结论:瑞格列奈联合二甲双胍较那格列奈联合二甲双胍在治疗2型糖尿病时,能更有效的降低糖化血红蛋白,同时两组低血糖和胃肠道反应的发生风险相似.由于本研究存在一定的局限性,因此结论的可靠性仍需多中心、大样本、高质量的RCT加以验证.
목적:탐토비교서격렬내연합이갑쌍고여나격렬내연합이갑쌍고치료2형당뇨병적료효화안전성.방법:검색PubMed、Medline、Cochrane도서관、EMbase、VIP、CNKI、만방수거고,안조Cochrane Handbook 5.1.0평개계통평개방법,사조서격렬내연합이갑쌍고화나격렬내연합이갑쌍고치료2형당뇨병적수궤대조시험(RCT),진행수거제취화질량평개후,채용RevMan 5.2연건진행Meta분석.결과:공납입5편RCT문헌,437례환자.Meta분석결과현시:재강저환자당화혈홍단백[MD = – 0.61,95%CI(– 0.64,– 0.58),P < 0.00001]방면,서격렬내연합이갑쌍고조우우나격렬내연합이갑쌍고조;재강저공복혈당[MD = – 0.46,95%CI(– 0.97,0.05),P = 0.08]화찬후2소시혈당[MD = 0.29,95%CI(– 0.92,1.50),P = 0.64]방면,량조몰유통계학차이;재저혈당반응발생솔[OR = 1.25,95%CI(0.34,4.58),P = 0.74]화위장도반응발생솔[OR = 1.02, 95%CI(0.31,3.32),P = 0.98]방면,량조적차이몰유통계학의의.결론:서격렬내연합이갑쌍고교나격렬내연합이갑쌍고재치료2형당뇨병시,능경유효적강저당화혈홍단백,동시량조저혈당화위장도반응적발생풍험상사.유우본연구존재일정적국한성,인차결론적가고성잉수다중심、대양본、고질량적RCT가이험증.
Objective:To evaluate the efifcacy and safety of repaglinide plus metformin versus nateglinide plus metformin in the treatment of type 2 diabetes mellitus.Methods:Databases including PubMed, Medline, Cochrane Library, EMbase, VIP, CNKI and Wanfang were searched. The quality of randomized controlled trial (RCT) found in the above databases was assessed by the Cochrane Handbook 5.1.0 evaluation system and meta-analysis was performed through RevMan 5.2 software.Results:A total of 5 RCTs including 437 patients met the inclusion criteria. Results of meta-analysis showed that HbA1c [MD =– 0.61, 95%CI (–0.64,–0.58),P < 0.000 01] was signiifcantly reduced in repaglinide plus metformin group compared with that in nateglinide plus metformin group. FPG [MD =– 0.46, 95%CI (–0.97, 0.05),P = 0.08] and 2 hPG [MD = 0.29, 95%CI (–0.92, 1.50),P = 0.64] in both groups showed no signiifcant difference. For the adverse drug reactions such as hypoglycemia [OR = 1.25, 95%CI (0.34, 4.58),P = 0.74] and gastrointestinal reactions [OR = 1.02, 95%CI (0.31, 3.32),P = 0.98], there were also no signiifcant differences between the two groups.Conclusion:Repaglinide plus metformin had better effect on decreasing glycosylated hemoglobin of type 2 diabetes mellitus patients compared with nateglinide plus metformin, and these two therapeutic regimens had similar risk of hypoglycemia and gastrointestinal reactions. While, further multicenter, large samples, high quality RCTs are warranted to verify the results of this article because of the research drawbacks.