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目的:评价格列苯脲及二甲双胍用于妊娠期糖尿病治疗的有效性、安全性。方法:检索1974年-2015年发表的关于格列苯脲及二甲双胍治疗妊娠期糖尿病的文献,根据纳入、排除标准筛选文献,提取相关数据,应用软件进行统计分析。结果:纳入7组随机对照试验,共2243个受试对象,其中4组为格列苯脲与胰岛素随机对照试验,余3组为二甲双胍与胰岛素随机对照试验。经分析,所纳入的研究不存在显著的临床异质性。发现格列苯脲组与胰岛素组及二甲双胍组与胰岛素组在不良妊娠结局方面,差异无统计学意义(P>0.05);但与胰岛素组相比,格列苯脲组及二甲双胍组可改善治疗依从性,且二甲双胍组较胰岛素组新生儿低血糖的发生降低(P=0.0002)。结论:格列苯脲及二甲双胍不增加不良围生期结局的发生率,故对胎儿的生长发育无不良影响,且二甲双胍可降低新生儿低血糖的发生率,故格列苯脲及二甲双胍可用于妊娠期糖尿病的治疗。
Objective: To evaluate the efficacy and safety of glibenclamide and metformin in the treatment of gestational diabetes mellitus. METHODS: The articles published between 1974 and 2015 on glyburide and metformin in gestational diabetes mellitus were searched. According to the inclusion criteria and the standard screening literature, relevant data were extracted and the software was used for statistical analysis. RESULTS: Seven randomized controlled trials were included, with a total of 2243 subjects, of whom 4 were randomized controlled trials of glibenclamide and insulin and the remaining 3 were metformin and insulin randomized controlled trials. After analysis, there was no significant clinical heterogeneity in the included studies. The results showed that there was no significant difference in adverse pregnancy outcomes between glibenclamide and insulin groups and metformin and insulin groups (P> 0.05), but glibenclamide and metformin groups improved the treatment compared with insulin group Compliance, and the occurrence of hypoglycemia in the metformin group were lower than those in the insulin group (P = 0.0002). Conclusion: Glibenclamide and metformin do not increase the incidence of adverse perinatal outcome, so the growth and development of the fetus had no adverse effects, and metformin can reduce the incidence of neonatal hypoglycemia, so glibenclamide and metformin can be used Gestational diabetes treatment.