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目的系统评价甘精胰岛素和地特胰岛素分别联用二甲双胍治疗中国人群2型糖尿病的临床疗效与安全性。方法计算机检索CNKI、CBM、VIP和万方数据库,收集甘精胰岛素对比地特胰岛素治疗2型糖尿病的的随机对照研究,检索年限均为建库至2016年2月,对纳入研究进行文献质量评价,采用Rev Man 5.2统计软件对同质性结果进行合并分析。结果共纳入10项研究,合计682例患者。Meta分析结果显示,甘精胰岛素和地特胰岛素对中国人群2型糖尿病患者在糖化血红蛋白〔MD=-0.11,95%CI(-0.30,0.01),P>0.05〕、空腹血糖〔MD=0.29,95%CI(-0.08,0.66),P>0.05〕差异性比较均无统计学意义,但在低血糖发生率〔RR=0.64,95%CI(0.43,0.96),P<0.05〕和体质量增加〔MD=-0.84,95%CI(-1.08,-0.59),P<0.05〕的差异性比较存在统计学意义。结论甘精胰岛素和地特胰岛素在控制血糖方面相似,但是地特胰岛素在低血糖发生率和患者体质量增加方面具有一定优势。鉴于纳入研究文献质量偏低,准确结果尚需大样本、高质量随机对照研究进一步验证。
Objective To evaluate the clinical efficacy and safety of insulin glargine and insulin detemir in combination with metformin in the treatment of type 2 diabetes in Chinese population. Methods The CNKI, CBM, VIP and Wanfang databases were searched by computer. A randomized controlled study was conducted to collect type 2 diabetes mellitus with insulin glargine contrast. The search period was from the establishment of the library to February 2016, and the quality of literature included in the study , Using Rev Man 5.2 statistical software for the merger analysis of homogeneity results. Results A total of 10 studies were included, totaling 682 patients. Meta-analysis showed that insulin glargine and insulin detemir had no significant difference in the glycosylated hemoglobin [MD = -0.11, 95% CI (-0.30, 0.01), P> 0.05), fasting blood glucose [MD = 95% CI (-0.08,0.66), P> 0.05]. There was no significant difference between the two groups in the incidence of hypoglycemia (RR = 0.64,95% CI 0.43,0.96, P <0.05) There was statistically significant difference between the two groups [MD = -0.84, 95% CI (-1.08, -0.59), P <0.05〕. Conclusions Glargine and insulin detemir are similar in controlling blood glucose, but detemir has some advantages in terms of the incidence of hypoglycemia and the increased body mass of patients. In view of the low quality of inclusion of research literature, accurate results still require large samples and high-quality randomized controlled studies to further verify.