摘要
目的:系统评价二肽基肽酶Ⅳ(DPP-4)抑制剂特力利汀治疗2型糖尿病的疗效,并采用Markov模型评估其长期疗效。方法:计算机检索Pub Med、The Cochrane Library、Embase和中国知网、万方医学网、维普等数据库,并追溯纳入的参考文献和手工检索相关杂志,时限为建库至2017年6月。由2位研究员根据事先制定的纳入排除标准筛选随机对照试验,提取文献基本信息及数据、评价文献质量。采用Rev Man5.3软件对疗效指标、安全性指标进行Meta分析,并建立Markov模型评估长期疗效。结果:共纳入5篇随机对照试验(RCT),包括糖尿病患者903例。Meta分析结果显示:特力利汀明显降低主要指标糖化血红蛋白[SMD=-0.87,95%CI(-0.99,-0.76),P<0.000 01]、降低次要指标空腹血糖[SMD=-0.71,95%CI(-0.85,-0.58),P<0.000 01],增加β细胞功能指数[SMD=0.46,95%CI(0.33,0.60),P<0.000 01],优于安慰剂对照组,差异有统计学意义(P<0.05);减少次要指标胰岛素抵抗指数方面,两组差异无统计学意义(P>0.05)。Markov模型结果表明,特力利汀可以降低糖尿病死亡人数。结论:新型降血糖药物DPP-4抑制剂特力利汀治疗2型糖尿病,降糖疗效显著,不增加低血糖的发生,还可以对胰岛β细胞功能起保护作用,降低糖尿病并发症和死亡的发生。
AIM： To investigate the long-term efficacy and safety of teneligliptin as dipeptidyl-peptidase Ⅳ（ DPP-4） inhibitor for type 2 diabetes mellitus and estimate the long-term efficacy. METHODS： Search the literature in databases of Pub Med,The Cochrane Library,Embase,CNKI,Wan Fang,CQVIP and so on. Randomized controlled trials（ RCT） of teneligliptin for the treatment of T2 DM were collected with time limit from establishment to June,2017. References and related professional magazine were also retrieved manually. Two researchers independently screened these literatures according to the inclusion and exclusion criteria,extracted basic information and assessed the methodological quality of included studies. Meta-analysis of the indexes was performed by using Rev Man 5. 3. Evaluate the long-term efficacy by establishing a new Markov model. RESULTS： Five RCTs were collected,including 903 diabetic patients. The results of meta-analysis showed teneligliptin can effectively reduce the main index Hb A1 c [SMD =-0. 87,95%CI（-0. 99,-0. 76）,P〈0. 000 01] and FPG[SMD =-0. 71,95% CI（-0. 85,-0. 58）,P〈0. 000 01],increase the secondary index HOMA-β[SMD = 0. 46, 95% CI（ 0. 33,0. 60）, P〈0. 000 01] than placebo group. And there was significant difference between them（ P〈0. 05）. And Markov model showed teneligliptin can decrease the numbers of death. CONCLUSION： As the new kind of hypoglycemic agent,dipeptidyl peptidase-Ⅳ（ DPP-4） inhibitor teneligliptin can reduce the blood glucose effectively with no increased risk of hypoglycemia,protect the β-cell function of type 2 diabetic mellitus and decrease the rate of diabetes complications and death.
作者
张春燕
范小冬
秦元
孔文强
周春阳
杜彪
ZHANG Chunyan;FAN Xiaodong;QIN Yuan;KONG Wenqiang;ZHOU Chunyang;DU Biao(School of Pharmacy, North Sichuan Medical College, Nanchong 637000, Sichuan, China;College of Phar- macy and Chemistry, Dali University, Dali 671000, Yunnan, China;School of Pharmacy, Southwest Medical University, Luzhou 646000, Sichuan , China;Department of Pharmacy, Chongqing Three Gorges Central Hos- pital, Chongqing 404000, China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2018年第1期65-72,共8页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
重庆市社会事业与民生保障科技创新专项(cstc2015shmszx120073)(cstc2017shmsA 130105)
重庆市万州区科技计划基金资助项目(201403055)
