摘要
目的:系统评价甘精胰岛素对比地特胰岛素治疗2型糖尿病的疗效与安全性,以为临床提供循证参考。方法:计算机检索Pub Med、EMBase、Cochrane图书馆、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,收集甘精胰岛素对比地特胰岛素治疗2型糖尿病疗效与安全性的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,采用Cochrane系统评价员手册5.1.0进行质量评价,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入18项RCT,合计3 638例患者。Meta分析结果显示,两组患者糖化血红蛋白水平比较,差异无统计学意义[MD=0.08,95%CI(-0.01,0.17),P=0.09];甘精胰岛素组患者空腹血糖水平显著低于地特胰岛素,差异有统计学意义[MD=0.15,95%CI(0.03,0.27),P=0.02]。两组患者低血糖发生率比较,差异无统计学意义[OR=0.97,95%CI(0.91,1.03),P=0.25];地特胰岛素组患者体质量增加程度显著低于甘精胰岛素组[MD=-0.95,95%CI(-1.06,-0.85),P=0.003],但注射部位反应发生率显著高于甘精胰岛素组[OR=2.28,95%CI(1.16,4.50),P=0.02],差异均有统计学意义。结论:甘精胰岛素治疗2型糖尿病的疗效优于地特胰岛素,注射部位反应发生率低于地特胰岛素,但体质量增加程度高于地特胰岛素。
OBJECTIVE：To systematically review the efficacy and safety of insulin glargine versus insulin detemir in the treat-ment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS：Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,randomized controlled trials （RCT） about the clinical efficacy and safety of insulin glargine versus insulin detemir in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation by Cochrane 5.1.0. RESULTS：A total of 18 RCTs,in-volving 3 638 patients were included. Results of Meta-analysis showed there was no significant difference in reducing glycosylated hemoglobin[MD=0.08,95%CI （-0.01,0.17）,P=0.09];fasting blood glucose level in insulin glargine group was significantly lower thaninsulin detemir,the difference was statistically significant [MD=0.15,95%CI（0.03,0.27）,P=0.02]. And there was no significant difference in the incidence of hypoglycemia [OR=0.97,95%CI（0.91,1.03）,P=0.25];the degree of body mass gain ininsulin detemir was significantly lower than insulin glargine group [MD=-0.95,95%CI（-1.06,-0.85）,P=0.003],but the in-cidence of injection site reactions was significantly higher than insulin glargine group [OR=2.28,95%CI（1.16,4.50）,P=0.02],the differences were statistically significant. CONCLUSIONS：The insulin glargine has better efficacy,than insulin detemir with lower incidence of injection site reactions but higher degree of body mass gain than insulin detemir in the treatment of type 2 diabetes.
出处
《中国药房》
CAS
北大核心
2016年第18期2524-2527,共4页
China Pharmacy
基金
国家科技支撑计划子课题(No.2013BAI06B04)
