利拉鲁肽与格列美脲治疗2型糖尿病的系统评价

目的 系统评价利拉鲁肽与格列美脲联合二甲双胍治疗2型糖尿病(T2DM)的有效性和安全性.方法 计算机检索PubMed、EMbase、The Cochrane Library、WanFang Database、CBM和CNKI数据库,纳入利拉鲁肽与格列美脲联合二甲双胍治疗T2DM的随机对照试验(RCT),检索时限截至2016年1月.由2位研究者按照纳入与排除标准筛选文献、提取资料、进行质量评价,采用RevMan5.3软件进行荟萃分析.结果 共纳入13个RCT.荟萃分析结果显示:与格列美脲联合二甲双胍组相比,利拉鲁肽联合二甲双胍组能更有效地降低HbA1c(WMD:-0.36,95％ CI:-0.67～-0.06,P=0.02)及体重(WMD:-3.11,95％ CI:-3.72～-2.51,P＜0.000 01);低血糖发生率低(WMD:-0.15,95％ CI:-0.19～-0.11,P＜0.000 01);但胃肠道等不良反应发生率更高(WMD:0.18,95％ CI:0.09 ～ 0.27,P＜0.000 1);降低空腹及餐后血糖效果相当.结论 与格列美脲联合二甲双胍组相比,利拉鲁肽联合二甲双胍组能更好的控制血糖、降低体重且低血糖发生率低.

Effects of liraglutide versus glimepiride for type 2 diabetes mellitus: a systematic review

Objective The efficacy and safety of liraglutide and glimepiride in combination with metformin in the treatment of type 2 diabetes mellitus (T2DM) were evaluated using systematic review.Methods Databases including Pubmed,EMbase,The Cochrane Library,WanFang Database,CBM and CNKI (updated to January,2016) were searched to collect randomized controlled trials which compared the effects of liraglutide with glimepiride in combination with mefformin in T2DM.Two researchers selected the documents,extracted the data and conducted the quality assessment according to literature inclusion and elimination standards.RevMan 5.3 was used for the meta-analysis.Results A total of 13 randomized controlled trials were included.Compared with glimepiride combined metformin group,liraglutide combined metformin group reduced HbA1c (WMD:-0.36,95％ CI:-0.67--0.06,P =0.02) and weight effectively (WMD:-3.11,95 ％ CI:-3.72--2.51,P ＜ 0.000 01),and had low incidence of hypoglycemia (WMD:-0.15,95％ CI:-0.19--0.11,P＜0.000 01),but the incidence of gastrointestinal adverse reactions was higher(WMD:0.18,95％ CI:0.09-0.27,P ＜0.000 1).There was no significant difference in fasting and postprandial blood glucose between two groups.Conclusion Compared with glimepiride combined metformin group,liraglutide combined metformin group has more advantages in blood glucose control and weight loss while has low incidence of hypoglycemia.