本文選題：天麥消渴片 + 型糖尿病��； 參考：《中藥新藥與臨床藥理》2017年06期

【摘要】：目的系統(tǒng)評(píng)價(jià)天麥消渴片對(duì)2型糖尿病患者胰島功能指標(biāo)的影響。方法計(jì)算機(jī)檢索中文全文期刊數(shù)據(jù)庫(CNKI),萬方數(shù)據(jù)庫(Wan Fang Data),中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(Sino Med),維普數(shù)據(jù)庫(VIP)、Pub Med、The Cochrane Library以及Embase數(shù)據(jù)庫,納入有關(guān)天麥消渴片對(duì)2型糖尿病患者胰島功能影響的隨機(jī)對(duì)照試驗(yàn)(RCT),檢索時(shí)限均為建庫至2017年9月,由2位研究者獨(dú)立進(jìn)行文獻(xiàn)篩選、資料提取及納入研究的質(zhì)量評(píng)價(jià),意見不一致時(shí)討論解決。結(jié)果納入23個(gè)隨機(jī)對(duì)照試驗(yàn)(RCT),結(jié)局指標(biāo)包括胰島素抵抗指數(shù)(HOMA-IR)、胰島β細(xì)胞基礎(chǔ)分泌指數(shù)(HOMA-β)、空腹血漿葡萄糖(FPG)、餐后2 h血糖(2h PPG)以及不良反應(yīng)。結(jié)果顯示,在降低HOMA-IR指標(biāo)方面,天麥消渴片降低胰島素抵抗指數(shù)作用優(yōu)于安慰劑(SMD=1.61,95%CI[1.20,2.03])P0.00001、噻唑烷二酮類(SMD=0.28,95%CI[0.03,0.53])P=0.03、雙胍類(SMD=1.43,95%CI[0.90,1.96])P0.00001、門冬胰島素(SMD=1.17,95%CI[0.75,1.59])P0.00001。此外,與噻唑烷二酮類(SMD=0.53,95%CI[0.07,0.98])P=0.02、糖苷酶抑制劑(SMD=1.05,95%CI[0.58,1.52])P0.00001、雙胍類(SMD=0.49,95%CI[0.28,0.71])P0.00001、磺脲類(SMD=8.57,95%CI[7.27,9.88])P0.00001聯(lián)用均顯示出增效作用;在升高HOMA-β指標(biāo)方面,天麥消渴片與雙胍類(SMD=0.75,95%CI[0.25,1.25])P=0.004、噻唑烷二酮類(SMD=0.59,95%CI[0.01,1.18])P=0.05、磺脲類(SMD=1.53,95%CI[1.08,1.99])P0.00001以及門冬胰島素(SMD=0.59,95%CI[0.16,1.02])P=0.008聯(lián)用均顯示出增效作用;在降低FPG指標(biāo)方面,天麥消渴片療效優(yōu)于安慰劑(SMD=2.55,95%CI[2.06,3.03])P0.00001,其次,分別與噻唑烷二酮(SMD=1.06,95%CI[0.34,1.79])P=0.004、糖苷酶抑制劑(SMD=0.78,95%CI[0.33,1.24])P=0.0008以及雙胍類(SMD=0.56,95%CI[0.43,0.70])P0.00001聯(lián)用療效更好;在降低2h PPG指標(biāo)方面,天麥消渴片療效優(yōu)于安慰劑(SMD=1.45,95%CI[1.05,1.85])P0.00001以及門冬胰島素(SMD=1.43,95%CI[1.00,1.86])P0.00001,其次與噻唑烷二酮(SMD=0.91,9 5%CI[0.47,1.36])P0.0001及雙胍類(SMD=0.51,95%CI[0.38,0.64])P0.00001聯(lián)用療效更好。此外,天麥消渴片與降糖藥物對(duì)比安全性較好。結(jié)論當(dāng)前證據(jù)表明,天麥消渴片能降低HOMA-IR、FPG以及2h PPG,與部分陽性藥物聯(lián)用可增加療效,且安全性較好。由于納入研究普遍存在方法學(xué)質(zhì)量問題,需要開展高質(zhì)量的研究予以驗(yàn)證。
[Abstract]:Objective to evaluate the effect of Tianmaixiaoke tablets on islet function in type 2 diabetic patients. Methods Chinese full-text periodical database (CNKI), Wan Fang data, Chinese biomedical literature database (Sino Med), VIP database (VIP), Pub Medbin the Cochrane Library and Embase database were searched by computer. A randomized controlled trial (RCT) was conducted on the effects of Tianmaixiaoke tablets on pancreatic islet function in type 2 diabetic patients. The retrieval time was from the establishment of the database to September 2017. The two researchers independently selected the literature, extracted the data and evaluated the quality of the study. Discuss a solution when there is disagreement. Results in 23 randomized controlled trials (RCT), the outcome indexes included insulin resistance index (HOMA-IR), basal secretion index of islet 尾 cells (HOMA- 尾), fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PPG) and adverse reactions. The results showed that Tianmaixiaoke tablet had a better effect on reducing insulin resistance index than placebo (SMD-1.61N95 CI [1.20 鹵2.03]) P0.00001, thiazolidone diketone (SMD-0.28995 CI [0.030.53]) P0.03, biguanidine (SMD1.4395CI [0.901.96]) P0.00001, aspartate insulin (SMD1.17995 CI [0.750.59]) P0.00001. the index of insulin resistance in Tianmaixiaoke tablet was better than that in placebo (SMD-1.61N95 CI [1.20 鹵2.03]), thiazolidanedione diketone (SMD-0.2895 CI [0.030.53]), biguanidine (SMD-1.4395CI [0.90 鹵1.96]). In addition, in combination with thiazolidinediketone (SMD-0.53-95CI [0.070.98]) P0.02, glucosidase inhibitor (SMD-1.0595CI [0.581.52]) P0.00001, biguanidine (SMD-0.49c95 CI [0.280.71]) P0.00001, sulfonylurea (SMD-8.57 / 95CI [7.279.88]) showed synergistic effects; in raising HOMA- 尾, 澶╅害娑堟復(fù)鐗囦笌鍙岃儘綾，

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