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本文旨在对基于肠促胰素药物治疗2型糖尿病合并非酒精性肝病的疗效和安全性进行系统评价和meta分析。全面检索Cochrane Library、EMBASE、Pub Med、CNKI、中国生物医学文献数据库CBM和万方中华医学会期刊数据库,纳入2015年7月之前发表的全部随机对照试验(RCT)。共纳入7个RCT的532名患者(干预组:264,对照组:268)。肠促胰素组显著降低患者谷丙转氨酶ALT(WMD–12.30,95%CI–17.53~–7.06)和BMI(WMD–2.64,95%CI–4.35~–0.94)。两组对患者血红蛋白(Hb A1c%)、天门冬氨酸转移酶(AST)、总胆固醇(TC)、甘油三酯(TG)和胰岛素抵抗指数(HOMA-RA)的改变无显著差别。有限的安全性资料显示不良反应可耐受。基于肠促胰素药物对ALT和BMI的改善效果较好,安全性尚可,可作为2型糖尿病合并非酒精性肝病患者的治疗选择,但研究质量有限。
This article aims to conduct a systematic review and meta-analysis of the efficacy and safety of the treatment of type 2 diabetes mellitus-based non-alcoholic liver disease based on incretin therapy. A comprehensive search of the Cochrane Library, EMBASE, Pub Med, CNKI, China Biomedical Literature Database CBM, and Wanfang Chinese Medical Association Journal databases was included in all randomized controlled trials (RCTs) published before July 2015. A total of 532 patients enrolled in the seven RCTs (intervention group: 264, control group: 268). The activity of alanine aminotransferase ALT (WMD-12.30, 95% CI-17.53 ~ -7.06) and BMI (WMD-2.64, 95% CI-4.35 ~ -0.94) were significantly decreased in the incretin group. There was no significant difference between the two groups in the changes of Hb A1c%, AST, TC, TG and HOMA-RA. Limited safety data indicate that adverse reactions are tolerable. Prostatins based on the improvement of ALT and BMI better effect, safety is acceptable, can be used as type 2 diabetes patients with non-alcoholic liver disease treatment options, but the quality of the study is limited.