二甲双胍联用氨氯地平治疗肥胖型高血压的Meta分析

目的 系统评价二甲双胍联合氨氯地平治疗肥胖型高血压的疗效与不良反应。方法 使用关键词检索Cochrane library、PubMed、EMbase、中国学术期刊全文数据库（CNKI）、中国生物医学全文数据库（CBM）、万方数据库，收集以二甲双胍联合氨氯地平（治疗组）相较于单用氨氯地平（对照组）治疗肥胖型高血压的随机对照试验（RCT），用RevMan 5.0软件进行Meta学分析，比较两组在降压、改善血糖及血脂水平方面的差异及安全性。结果 共纳入15个RCT，计1 389例患者。Meta分析结果显示：二甲双胍联合氨氯地平较单独用氨氯地平更能有效地降低肥胖型高血压患者的血压RR=1.22，95%CI（1.14，1.29）]，且联合用药组能有效改善空腹血糖水平WMD=-0.42 mmol/L，95%CI（-0.69，-0.14）]及糖化血红蛋白水平WMD=-0.11 mmol/L，95%CI（-1.81，-0.40）]，两组不良反应发生率比较无统计学差异（RR=0.22，95%CI（0.04，1.38）P=0.11]。结论 肥胖型高血压患者接受二甲双胍联合氨氯地平治疗，较单用氨氯地平能有效地降压、改善血糖及糖化血红蛋白水平，而不增加不良反应。

Meta-analysis of metformin plus amlodipine for obesity related hypertension

Objective To assess the effectiveness and adverse drug reaction of metformin plus amlodipine in patients with obesity related hypertension. Methods Based on the keywords retrieval way, Cochrane Library, PubMed, Embase, China Biomedical Literature Database, China Journal Fulltext Database, and Wanfang database were searched. Randomized controlled trials (RCTs) of metformin plus amlodipine versus amlodipine for obesity related hypertension were included. The quality of the RCTs included were assessed, software RevMan 5.0 was used for Meta-analysis. The differences in blood pressure, glucose and lipid levels were compared between metformin plus amlodipine group and amlodipine group. Results A total of 15 RCTs and 1389 patients were included. Meta analysis showed that the blood pressureRR=1.22, 95%CI(1.14, 1.29)] was more effectively reduced, and fasting plasma glucose levelsWMD=-0.42 mmol/L, 95%CI(-0.69, -0.14)] and HbA1c levelsWMD=-0.11 mmol/L, 95%CI(-1.81, -0.40)] were improved significantly with metformin plus amlodipine therapy. Furthermore, there was no significant difference in the incidence of adverse reaction between two groups(RR=0.22, 95%CI(0.04, 1.38, P=0.11)]. Conclusion Current evidence demonstrates that combination treatment with metformin plus amlodipine improve blood glucose level, HbA1c level and attenuate blood pressure more effectively without increasing the adverse reaction.