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目的系统评价伊格列净治疗2型糖尿病的疗效和安全性。方法计算机检索PubMed、Cochrane Library、Embase、中国知网、万方医学网、维普全文数据库、中国生物医学文献数据库等,获取伊格列净治疗2型糖尿病的随机对照试验(RCT),检索时限均为建库至2017年2月,并追溯纳入文献的参考文献,由2位研究员根据纳入与排除标准筛选试验、提取资料、评价文献质量并交叉核对结果,采用RevMan5.20软件对各项指标进行Meta分析。结果共纳入7篇RCT,1 267例2型糖尿病患者,Meta分析结果显示,伊格列净组在糖化血红蛋白(HbA1c)、HbA1c<7%达标率及体重控制方面均优于对照组,差异有显著意义[MD=-0.98,95%CI(-1.20,-0.77),P<0.01;OR=3.99,95%CI(2.69,5.91),P<0.01;MD=-1.70,95%CI(-2.28,-1.12),P<0.01]。在安全性方面,伊格列净组严重不良反应、低血糖、尿路感染、生殖器感染的发生率与对照组相当,差异无显著意义[OR=0.48,95%CI(0.22,1.07),P=0.07;OR=1.57,95%CI(0.43,5.71),P=0.49;OR=1.22,95%CI(0.59,2.52),P=0.59;OR=1.14,95%CI(0.41,3.21),P=0.8]。结论伊格列净能较好控制2型糖尿病患者的HbA1c和体重,不良反应发生率低,安全性较高。
Objective To evaluate the efficacy and safety of ipagliflozin in the treatment of type 2 diabetes mellitus. Methods Randomized controlled trials (RCTs) were obtained from PubMed, Cochrane Library, Embase, CNKI, Wanfang Medical Network, VIP database and Chinese Biomedical Literature Database. For the construction of the library until February 2017, and retrospectively incorporated into the literature references, two researchers based on inclusion and exclusion criteria screening test, extract data, evaluate the quality of the literature and cross-check the results, the use of RevMan5.20 software for each indicator Meta analysis. Results A total of 7 RCTs and 1 267 patients with type 2 diabetes mellitus were included in the analysis. The results of Meta analysis showed that the patients in the glibenclamide group were better than the control group in achieving HbA1c and HbA1c <7% compliance rate and body weight control Significant [MD = -0.98, 95% CI -1.20, -0.77, P <0.01 OR = 3.99,95% CI 2.69,5.91, P <0.01 MD = -1.70,95% CI (- 2.28, -1.12), P <0.01]. In terms of safety, the incidence of severe adverse reactions, hypoglycemia, urinary tract infections and genital infections in the novariacetin group was similar to that in the control group, with no significant difference [OR = 0.48, 95% CI (0.22, 1.07), P = 0.07; OR = 1.57, 95% CI 0.43, 5.71; P = 0.49; OR = 1.22 95% CI 0.59, 2.52 P = 0.59 OR = 1.14 95% CI 0.41, 3.21, P = 0.8]. Conclusion Igboy net can better control HbA1c and body weight in patients with type 2 diabetes, with a lower incidence of adverse reactions and higher safety.