伏格列波糖治疗2型糖尿病的荟萃分析

·论著·

伏格列波糖治疗2型糖尿病的荟萃分析

张誉艺，鲍思蔚，翟晓波，何志高*(同济大学附属东方医院药学部，上海 200120)

[摘要]目的：系统评价伏格列波糖与安慰剂比较对2型糖尿病病人的疗效及安全性。方法：检索Medline、Pubmed、Embase、Cochrane图书馆、中文科技期刊数据库(维普，VIP)、中国知网(CNKI)及万方数据-数字化期刊群，纳入随机对照试验，用Review Manager 5.0软件进行荟萃分析。 结果：共有9项研究2357例病人纳入系统评价，伏格列波糖单药治疗降低HbA1c水平的疗效优于对照组[均数差(MD)=-0.28，95% CI(-0.42，-0.13)，P=0.000 2]。两组在控制体重方面效果相似[MD=0.10，95% CI(-0.12，0.33)，P=0.37]，不良反应发生率无显著性差异[相对风险度(RR)=1.40，95% CI(0.97，2.02)，P=0.07]。联合其他口服降糖药或胰岛素治疗时，伏格列波糖降低HbA1c水平的疗效优于对照组[MD=-1.50，95% CI (-1.98，-1.02)，P<0.000 01]，对于体重的控制优于对照组[MD=-0.89，95% CI (-1.58，-0.20)，P=0.01]，两组不良反应发生率差异无统计学意义[RR=1.80，95% CI (0.95，3.43)，P=0.07]。结论：伏格列波糖可以改善2型糖尿病病人的餐后血糖，且安全性良好。

[关键词]伏格列波糖；糖尿病，2型；荟萃分析

[中图分类号]R977.15[文献标志码]A

DOI：10.5428/pcar20150110

基金项目“十二五”国家科技支撑计划课题(2013BAI06B04)

作者简介张誉艺(女)，硕士生，药师.

[收稿日期]2014-05-13

Meta-analysis of voglibose in the treatment of patients with type 2 diabetes

ZHANG YuYi，BAO SiWei，ZHAI XiaoBo，HE ZhiGao*(Department of Pharmacy，East Hospital Affiliated to Tongji University，Shanghai 200120，China)

ABSTRACT[]Objective: To systematically evaluate the efficacy and safety of voglibose versus placebo in the treatment of patients with type 2 diabetes. Methods: Literature was retrieved from Medline, Pubmed, Embase, Cochrane Library, China Science and Technology Journal Database (VIP), China Knowledge Resource Integrated Database (CNKI) and Wanfang data and the retrieved papers were included in the randomized controlled trials. Software Review Manager 5.0 was used for meta-analysis. Results: Nine studies involving 2357 patients were included for systematic evaluation. Research showed that the efficacy of voglibose as mono-therapy on the reduction of hemoglobin Alc (HbAlc) was obviously superior to that of the control group [mean difference (MD)=-0.28, 95% CI (-0.42,-0.13), P=0.000 2]. However, the effects of voglibose and the placebo were identical in the control of weight[MD=0.10, 95% CI (-0.12, 0.33), P=0.37]. No significance differences could be noted in adverse drug reactions[relative risk (RR) =1.40, 95% CI (0.97, 2.02), P=0.07]. The effects of voglibose combined with other oral anti-hyperglycemic drugs or insulin on the reduction of HbAlc levels were also superior to those of the control group [MD=-1.50, 95% CI (-1.98,-1.02), P<0.000 01], and its effect on weight control was also superior to that of the control[MD=-0.89, 95% CI (-1.58,-0.20), P=0.01]. No statistical significance could be noticed in the occurrence of adverse drug reactions [RR=1.80, 95% CI (0.95, 3.43), P=0.07]. Conclusion: Voglibose could effectively improve postprandial blood glucose and was safe in the treatment of patients with type 2 diabetes.

[KEY WORDS]voglibose; diabetes, type 2; meta-analysis

[Pharm Care Res，2015，15(1): 31-34]

E-mail: yuyi0924@126.com

*通信作者(Corresponding author)：何志高，E-mail：zhigaohe@hotmail.com

近30年来，我国糖尿病患病率显著增加。2007-2008年，在中华医学会糖尿病学分会组织下，全国14个省市进行了糖尿病的流行病学调查。结果显示我国20岁以上的成年人糖尿病患病率为9.7%[1]。α-葡萄糖苷酶抑制剂能选择性作用于小肠黏膜刷状缘上的葡萄糖苷酶，抑制多糖及蔗糖分解成单糖，延缓碳水化合物的消化，减少葡萄糖吸收，能较好地改善餐后高血糖。伏格列波糖是一种α-葡萄糖苷酶抑制剂，本研究采用回顾性分析方法，评价伏格列波糖治疗2 型糖尿病的疗效和安全性，以期为临床应用提供循证医学证据。……