本文選題：格列齊特 + 格列吡嗪��； 參考：《鄭州大學(xué)》2015年碩士論文

【摘要】：目的:采用Meta分析方法系統(tǒng)評(píng)價(jià)格列齊特和格列吡嗪治療2型糖尿病的療效和安全性,并對(duì)格列齊特和格列吡嗪治療2型糖尿病的成本—效果進(jìn)行分析,為臨床用藥合理性經(jīng)濟(jì)性提供證據(jù)。方法:檢索萬方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)、維普期刊資源綜合服務(wù)平臺(tái)、中華醫(yī)學(xué)會(huì)期刊全文數(shù)據(jù)庫、Medline從建庫至2014年12月公開發(fā)表的關(guān)于格列吡嗪與格列齊特在治療2型糖尿病的隨機(jī)對(duì)照試驗(yàn)。由兩名評(píng)價(jià)員按照納入標(biāo)準(zhǔn)篩選文獻(xiàn),采用Review Manager 5軟件對(duì)納入研究進(jìn)行Meta分析,并分析合并計(jì)算研究的異質(zhì)性、敏感性及發(fā)表偏倚,根據(jù)需要選用隨機(jī)效應(yīng)模型合并計(jì)算。結(jié)果:共納入11篇研究文獻(xiàn),質(zhì)量等級(jí)均為C級(jí)。采用Review Manager 5軟件Meta分析結(jié)果:①格列齊特和格列吡嗪治療2型糖尿病的總有效率差異無統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=1.41,95%CI=(0.72,2.75)];敏感性分析分別采用M-H法固定效應(yīng)模型和隨機(jī)效應(yīng)模型與Peto法固定效應(yīng)模型比較,結(jié)果變化微小,顯示敏感性低,結(jié)果穩(wěn)定性高;發(fā)表偏倚分析所繪漏斗圖顯示左右基本對(duì)稱,可以認(rèn)為發(fā)表偏倚可能性小。②格列齊特和格列吡嗪治療2型糖尿病的顯效率差異無統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=1.01,95%CI=(0.59,1.72)];敏感性分析分別采用M-H法固定效應(yīng)模型和隨機(jī)效應(yīng)模型與Peto法固定效應(yīng)模型比較,結(jié)果基本沒有變化,顯示敏感性低,結(jié)果穩(wěn)定性高;發(fā)表偏倚分析漏斗圖左右基本對(duì)稱,顯示發(fā)表偏倚可能性很小。③格列齊特和格列吡嗪治療2型糖尿病的不良反應(yīng)發(fā)生率差異無統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=1.27,95%CI=(0.62,2.59)];敏感性分析分別采用M-H法固定效應(yīng)模型和隨機(jī)效應(yīng)模型與Peto法固定效應(yīng)模型比較,結(jié)果變化較大,顯示敏感性高,結(jié)果穩(wěn)定性低,尚不能認(rèn)為二者的不良反應(yīng)發(fā)生率無統(tǒng)計(jì)學(xué)意義;發(fā)表偏倚分析所繪漏斗圖顯示左右基本對(duì)稱,可以認(rèn)為發(fā)表偏倚可能性小。④格列齊特和格列吡嗪治療2型糖尿病空腹血糖(FPG)平均降低程度差異無統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=-0.34,95%CI=(-0.87,0.20)]。⑤格列齊特和格列吡嗪治療2型糖尿病空腹血糖治療結(jié)果差異有統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=0.33,95%CI=(0.13,0.52)],格列吡嗪治療后的空腹血糖水平低于格列齊特,格列吡嗪的療效優(yōu)于格列齊特。⑥格列齊特和格列吡嗪治療2型糖尿病餐后2小時(shí)血糖(2h PG)治療結(jié)果差異無統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=0.04,95%CI=(-0.24,0.32)]。⑦格列齊特和格列吡嗪治療2型糖尿病糖化血紅蛋白結(jié)果差異有統(tǒng)計(jì)學(xué)意義[P0.05,OR合并=0.25,95%CI=(0.05,0.45)],格列吡嗪治療后的糖化血紅蛋白水平低于格列齊特,格列吡嗪的療效優(yōu)于格列齊特。⑧對(duì)格列齊特和格列吡嗪治療2型糖尿病進(jìn)行療效及治療費(fèi)用進(jìn)行比較,結(jié)果顯示除了在空腹血糖治療結(jié)果和糖化血紅蛋白治療結(jié)果方面,格列吡嗪優(yōu)于格列齊特外,其它方面療效基本相似,但是格列吡嗪治療費(fèi)用較低。結(jié)論:Meta分析結(jié)果表明:格列齊特和格列吡嗪治療2型糖尿病總有效率、顯效率、不良反應(yīng)發(fā)生率、空腹血糖平均降低程度、餐后2小時(shí)治療結(jié)果等方面差異無統(tǒng)計(jì)學(xué)意義;在空腹血糖治療結(jié)果和糖化血紅蛋白治療結(jié)果方面,格列吡嗪優(yōu)于格列齊特;藥物經(jīng)濟(jì)學(xué)方面,格列吡嗪較為經(jīng)濟(jì)合理。
[Abstract]:Objective: to systematically evaluate the efficacy and safety of gliclazide and glipizide in the treatment of type 2 diabetes by Meta analysis, and to analyze the cost effect of gliclazide and glipizide in the treatment of type 2 diabetes and provide evidence for the rationality and economy of clinical medication. Methods: to retrieve the knowledge service platform of Wanfang Data, and the information of VIP periodicals. The source comprehensive service platform, the full text database of the Chinese Medical Association, Medline from the library to December 2014, published publicly on the randomized controlled trial of glipizide and gliclazide in the treatment of type 2 diabetes. Two evaluators were selected in accordance with the inclusion criteria and used the Review Manager 5 software to carry out Meta analysis of the included studies, and divided them into a study. Analysis of the heterogeneity, sensitivity, and publication bias of the combined calculation, according to the needs of the random effect model combined calculation. Results: a total of 11 research papers were included, the quality grade was C grade. Review Manager 5 software Meta analysis results were used: (1) there was no statistical difference in the total effective difference between glipizide and glipizide treated type 2 diabetes. P0.05, OR combined with =1.41,95%CI= (0.72,2.75)]; the sensitivity analysis was compared with the fixed effect model of M-H method and random effect model and the fixed effect model of Peto method respectively, the result was small, the sensitivity was low, the result was high, and the funnel plot of the publication bias analysis showed that the funnel plot was basically symmetrical, and the possibility of publishing bias was small. There was no significant difference between glicizide and glipizide in the treatment of type 2 diabetes with no significant difference [P0.05, OR combined with =1.01,95%CI= (0.59,1.72)]; sensitivity analysis was compared with the fixed effect model of M-H method and random effect model and Peto fixed effect model, and the results showed that the sensitivity was low and the result was high. The table bias analysis showed that the funnel map was basically symmetrical and showed that the possibility of publication bias was very small. (3) there was no significant difference in the incidence of adverse reactions between gliclazide and glipizide in the treatment of type 2 diabetes, [P0.05, OR combined with =1.27,95%CI= (0.62,2.59)]. The sensitivity analysis was fixed by the M-H fixed effect model and the random effect model and the Peto method, respectively. Compared with the fixed effect model, the results changed greatly, the sensitivity was high and the result was low. The incidence of adverse reactions was not statistically significant in the two cases. The funnel plot of the published bias analysis showed that the left and right symmetry of the left and right sides could be considered. (4) gliclazide and glipizide were used to treat the fasting blood glucose of type 2 diabetes. (FPG) the difference in average reduction was not statistically significant [P0.05, OR combined with =-0.34,95%CI= (-0.87,0.20)]. 5. The difference between glicizide and glipizide in the treatment of type 2 diabetes was statistically significant [P0.05, OR combined with =0.33,95%CI= (0.13,0.52)], and glipizide was lower than glicizine, glipizide, and glipizide The effect of gliclazide and glipizide was better than that of glicizide and glipizide in the treatment of type 2 diabetes after a meal of 2 hours of blood glucose (2H PG), there was no statistical significance [P0.05, OR combined with =0.04,95%CI= (-0.24,0.32)]. 5%CI= (0.05,0.45)), glipizide treated glycosylated hemoglobin levels were lower than glicizide. Glipizide was better than glicizide. The results were compared with glicizide and glipizide in the treatment of type 2 diabetes. The results showed that the results of glycemic hemoglobin and glycated hemoglobin were the result of the treatment. Glipizide was better than gliclazide, and other aspects were similar, but glipizide had a lower cost. Conclusion: Meta analysis showed that gliclazide and glipizide were effective in the treatment of type 2 diabetes, the rate of significant effect, the incidence of adverse reactions, the average decrease in fasting blood glucose, and the difference in the 2 hours after the meal. There is no statistical significance; glipizide is superior to gliclazide in the results of fasting blood glucose treatment and glycosylated hemoglobin, and glipizide is more economical and reasonable in pharmacoeconomics.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

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本文編號(hào)：1900130