摘要
目的:评价中西药联合干预治疗糖尿病前期的疗效和安全性。方法:检索中国期刊全文数据库(CNKI)、万方数据库、VIP、CBM、Cochrane图书馆、Embase、PubMed、web of science、swetswise linker,检索时限截至2019年6月。纳入中西药联合干预治疗糖尿病前期的随机对照实验(RCT)。由2位研究人员根据纳入与排除标准,独立进行文献筛选、数据提取、质量评价、并交叉核对结果,采用RevMan5.3软件进行Meta分析。结果:共纳入19个RCT,共1584例糖尿病前期患者。Meta分析显示中西联合用药组与对照组比较,有效率升高[RR=1.25,95%CI(1.17,1.33),P<0.00001],对HbA1c[WMD=0.40,95%CI(0.25,0.56),P<0.00001]、FPG[WMD=0.53,95%CI(0.41,0.66),P<0.00001]、2hPG[WMD=0.62,95%CI(0.50,0.74),P<0.00001]、TG[WMD=0.26,95%CI(0.07,0.45),P=0.007]的影响其差异有统计学意义;对HOMA-IR[WMD=0.19,95%CI(-0.10,0.47),P=0.20]、TC[WMD=0.32,95%CI(-0.07,0.70),P=0.11]、FINS[WMD=0.18,95%CI(-0.07,0.44),P=0.16]的影响其差异无统计学意义。19篇被纳入的文献中,仅有10篇文献提及不良反应,其中有4个研究报导了不良反应发生率,中西药联用组不良反应发生率低于对照组,差异均有统计学意义(P<0.05);其余9篇文献未提及安全性和不良反应,所有文献均未见严重的不良反应报道。结论:基于当前临床证据初步得出,中西药联合干预治疗糖尿病前期的方法可能优于单纯西药治疗。但纳入文章研究设计质量不高,可能存在发表偏倚,因此本研究结果仍需大样本多中心随机对照试验进一步验证。
Objective: To assess curative effects and the safety of integrative medicine in the intervention for prediabetes. Methods: Randomized controlled trials(RCTs) of integrative medicine in the treatment for prediabetes were searched in CNKI, Wanfang, VIP, CBM, Cochrane library, Embase, PubMed, web of science and swetswise linker by June, 2019. According to the inclusion and exclusion criteria, the papers were screened, the data was abstracted, quality was assessed and the results were checked by two researchers independently, RevMan 5.3 software was used to perform Meta analysis. Results: All 19 RCTs were included, involving 1 584 patients. Meta analysis demonstrated: integrative medicine group was compared with the control group, effective rate rose [RR=1.25,95%CI(1.17, 1.33), P<0.000 01], the difference showed statistical meaning in its effects on HbA1 [WMD=0.40,95%CI(0.25, 0.56), P<0.000 01], FPG[WMD=0.53, 95%CI(0.41, 0.66), P<0.000 01], 2 hPG[WMD=0.62, 95%CI(0.50, 0.74), P <0.00 001] and TG [WMD=0.26, 95%CI(0.07, 0.45), P=0.007];the difference had no statistical meaning in its effects on HOMA-IR [WMD=0.19, 95%CI(-0.10, 0.47), P=0.20], TC [WMD=0.32, 95%CI(-0.07,0.70), P=0.11] and FINS [WMD=0.18, 95%CI(-0.07, 0.44), P=0.16]. Among 19 papers, only ten papers refered to side effects, among them, four studies have reported the incidence of side effects, integrative medicine group was lower than the control group notably, and the difference had statistical meaning(P <0.05);the rest nine papers haven’t mentioned the safety and side effects, no severe side effects have been reported in all the papers. Conclusion:Based on the current clinical evidence, the method of integrative medicine in treating prediabetes might be superior to only Western medicine. Because the quality of experimental design in the included paper is low, publication bias might existed, the result needs to be testified in large-sample multicentered randomzied controlled trials.
作者
李翔
李喜香
刘军刚
LI Xiang;LI Xixiang;LIU Jungang(Pharmacy College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Pharmacy Department,Gansu Provincial Hospital of Traditional Chinese Medicine)
出处
《西部中医药》
2020年第1期72-78,共7页
Western Journal of Traditional Chinese Medicine
基金
甘肃省中医药综合防治重大疑难疾病项目(GZKZD-2018-01)。
作者简介
李翔(1994-),女,在读硕士研究生。研究方向:中药制药工艺;通讯作者:李喜香(1968-),女,硕士学位,硕士研究生导师,主任中药师。研究方向:中药新制剂研发。
