首页> 中文期刊> 《中国医院用药评价与分析》 >阿卡波糖联合胰岛素治疗1型糖尿病的系统评价

阿卡波糖联合胰岛素治疗1型糖尿病的系统评价

         

摘要

OBJECTIVE:To systematically evaluate the efficacy and safety of acabose in treatment of patients with type 1 diabetes mellitus.METHODS: Pubmed, Cochrane Library , China Biology Medicine , VIP and CNKI were retrieved , and the RCT of acarbose in treatment of type 1 diabetes were screened , Meta-analysis was conducted on the included literatures by using Rev Man 5.2 software .RESULTS:Four RCTs were involved .According to the results of Meta-analysis , there was no statistical significance between acabose group and placebo group in reducing glycosylated hemoglobin levels(SMD=-0.45,95%CI=-0.98-0.01,P=0.06), body weight(SMD=-0.26,95%CI=-1.07-0.54,P=0.52), and the incidence of hypoglycemia (SMD=0.28,95%CI=-2.45-3,P=0.84).The difference was statistically significant in insulin administration (SMD=-0.34,95%CI=-0.52--0.15,P=0.000 3), and incidence of adverse drug reactions (OR=5.75,95%CI=3.56-9.27,P<0.000 01).CONCLUSIONS:Based on the results of the included literatures , the effects of acarbose in treatment of type 1 diabetes are safe and effective , which can improve the glucose level and reduce the insulin administration , without increasing body weight and hypoglycemia , and has no significant effects on glycosylated hemoglobin levels .However , the occurrence of diarrhea and abdominal pain and some other gastrointestinal reaction were more frequent in acarbose -treated patients .Therefore , it is still necessary to carry out well-designed large scale RCTs and longer follow-up studies for the further confirmation .%目的:系统评价阿卡波糖联合胰岛素治疗1型糖尿病的有效性和安全性。方法:计算机检索Pubmed、Cochrane Library、中国生物医学文献数据库、维普数据库及中国知网数据库,筛选阿卡波糖联合胰岛素治疗1型糖尿病随机对照试验,采用Rev Man 5.2软件对纳入文献进行荟萃(Meta)分析。结果:共纳入4个随机对照试验,Meta分析结果显示,阿卡波糖组与安慰剂组在降低糖化血红蛋白水平方面的差异无统计学意义(SMD=-0.45,95%CI=-0.98~0.01,P=0.06);2组患者胰岛素用量的差异有统计学意义(SMD=-0.34,95%CI=-0.52~-0.15,P=0.0003);2组患者体质量的差异无统计学意义(SMD=-0.26,95%CI=-1.07~0.54,P=0.52);2组患者不良反应发生率的差异有统计学意义(OR=5.75,95%CI=3.56~9.27,P<0.00001),但低血糖发生次数的差异无统计学意义(SMD=0.28,95%CI=-2.45~3,P=0.84)。结论:基于所纳入的文献研究结果,阿卡波糖联合胰岛素治疗1型糖尿病是安全、有效的,能改善患者血糖水平,减少胰岛素用量,同时不增加体质量和发生低血糖,但对糖化血红蛋白无显著影响,阿卡波糖组患者腹泻、腹痛等胃肠道反应发生率更高。上述结论仍需开展大规模设计良好的随机对照研究和更长时间的随访来进一步验证。

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