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二甲双胍联合阿卡波糖与单药治疗2型糖尿病的Meta分析

Metformin combined with acarbose vs. single medicine in the treatment of type 2 diabetes: A meta-analysis.

作者信息

Liu Zhongjie, Zhao Xiaodong, Sun Weiwei, Wang Yaoxian, Liu Shangjian, Kang Lei

机构信息

Department of Nephropathy and Endocrinology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, P.R. China.

Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, P.R. China.

出版信息

Exp Ther Med. 2017 Jun;13(6):3137-3145. doi: 10.3892/etm.2017.4333. Epub 2017 Apr 13.

Abstract

The present meta-analysis aimed to evaluate metformin combined with acarbose compared with monotherapy with either of the two drugs for type 2 diabetes (T2DM). Relevant trials were retrieved through searching PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, Wanfang and Chongqing VIP information network databases. Heterogeneous and homogeneous data were statistically combined using a random- and fixed-effects model, respectively. For dichotomous and continuous data, the merged effect size was presented as the risk ratio (RR) and weighted mean differences (WMD), respectively, with 95% confidence interval (CI). All included studies were divided into subgroups. A Funnel plot was used to detect publication bias. Review Manager 5.2 software was applied to perform the statistical analyses. Meta-analysis revealed that compared with metformin monotherapy, combined therapy was significantly more efficacious regarding indexes including the total effective rate, fasting blood glucose (FBG), blood glucose levels at two post-prandial hours (2HPG) and hemoglobin A1C (HbA1c). Similarly, combined therapy showed advantages on indexes including FBG, 2HPG and HbA1c over acarbose therapy after 4 months of treatment. In conclusion, the findings of the present meta-analysis suggested that combined therapy of metformin and acarbose appears to be more efficacious than metformin or acarbose monotherapy.

摘要

本荟萃分析旨在评估二甲双胍联合阿卡波糖与两种药物单药治疗2型糖尿病(T2DM)的疗效。通过检索PubMed、Embase、Cochrane图书馆、中国知网、万方和维普资讯网数据库获取相关试验。分别使用随机效应模型和固定效应模型对异质性和同质性数据进行统计学合并。对于二分类数据和连续性数据,合并效应量分别以风险比(RR)和加权平均差(WMD)表示,并给出95%置信区间(CI)。所有纳入研究均分为亚组。采用漏斗图检测发表偏倚。应用Review Manager 5.2软件进行统计分析。荟萃分析显示,与二甲双胍单药治疗相比,联合治疗在总有效率、空腹血糖(FBG)、餐后两小时血糖(2HPG)和糖化血红蛋白(HbA1c)等指标上显著更有效。同样,治疗4个月后,联合治疗在FBG、2HPG和HbA1c等指标上比阿卡波糖单药治疗更具优势。总之,本荟萃分析结果表明,二甲双胍与阿卡波糖联合治疗似乎比二甲双胍或阿卡波糖单药治疗更有效。

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本文引用的文献

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Metformin: new understandings, new uses.二甲双胍:新认识,新用途。
Drugs. 2003;63(18):1879-94. doi: 10.2165/00003495-200363180-00001.

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