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目的:系统评价沙格列汀联合二甲双胍对比阿卡波糖联合二甲双胍治疗2型糖尿病的有效性与安全性,以为临床治疗提供循证参考。方法:计算机检索中国知识资源总库(CNKI)、中文科技期刊数据库(VIP)、中国学术期刊数据库(万方数据)、中国生物医学文献服务系统(Sino Med)、Pub Med、Embase、Cochrane Library、Clinicaltrials.com,收集沙格列汀联合二甲双胍对比阿卡波糖联合二甲双胍治疗2型糖尿病的随机对照试验(RCT),采用Revman 5.3软件进行Meta分析。结果:共纳入7项研究,包含1 065例患者。Meta分析结果显示,与阿卡波糖联合二甲双胍相比,沙格列汀联合二甲双胍可以显著降低2型糖尿病患者的糖化血红蛋白水平(Hb A1c)[MD=-0.39,95%CI(-0.66,-0.12),P=0.005],空腹血糖(FBG)[MD=-0.39,95%CI(-0.66,-0.12),P=0.005],餐后2h血糖水平(2h PG)[MD=-0.93,95%CI(-1.57,-0.29),P=0.005],提高空腹胰岛素水平(F-Ins)[MD=0.58,95%CI(0.31,0.85),P<0.0001],降低胰岛素抵抗指数(HOMA-IR)[MD=-0.27,95%CI(-0.41,-0.12),P=0.0003],而对于体重指数(BMI)水平无显著性影响(P>0.05),胃肠道不良反应发生率低[OR=0.07,95%CI(0.01,0.37),P=0.002]。结论:沙格列汀联合二甲双胍治疗2型糖尿病疗效和安全性较好。
OBJECTIVE: To systematically evaluate the efficacy and safety of saxagliptin plus metformin versus acarbose plus metformin in the treatment of type 2 diabetes, providing an evidence-based reference for clinical treatment. Methods: CNKI, VIP, China Academic Journal Database, Sino Med, Pub Med, Embase, Cochrane Library, Clinicaltrials.com, a Randomized Controlled Trials (RCT) trial of saxagliptin combined with metformin vs acarbose in combination with metformin for Type 2 diabetes was performed and Meta-analysis was performed using Revman 5.3 software. Results: A total of 7 studies were included, including 1,065 patients. Meta-analysis showed that compared with metformin plus acarbose, sotalol and metformin significantly reduced HbA1c in patients with type 2 diabetes (MD = -0.39, 95% CI, -0.66, - 0.12), P = 0.005], fasting plasma glucose (FBG) [MD = -0.39,95% CI -0.66, -0.12, P = 0.005] (MD = 0.58, 95% CI (0.31, 0.85), P <0.0001] and decreased the insulin resistance index (HOMA -IR) [MD = -0.27,95% CI (-0.41, -0.12), P = 0.0003], but no significant effect on body mass index (BMI) (P> 0.05) Low [OR = 0.07, 95% CI (0.01, 0.37), P = 0.002]. Conclusion: Saxagliptin and metformin are effective and safe in the treatment of type 2 diabetes mellitus.