格列美脲治疗2型糖尿病有效性及安全性系统评价_《中国循证医学杂志》

作者：

柳汝明 ^1,2 , 贾萍 ³ , 唐尧 ¹

1. 四川大学华西医院药剂科（成都 610041）；2. 四川大学华西药学院（成都 610041）；3. 四川省妇幼保健医院药剂科（成都 610041）;

关键词：

格列美脲 2 型糖尿病有效性安全性系统评价

DOI：

10.7507/1672-2531.20090193

视频：

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目的　系统评价格列美脲治疗2 型糖尿病的有效性及安全性。
方法　计算机检索PubMed、Ovid（All EBM Reviews）、CNKI、万方、维普、CBM。按Cochrane 系统评价的方法评价纳入研究质量，对同质研究采用RevMan 5.0 进行Meta 分析，对数据不能合并者，则进行描述性的定性分析。
结果　本研究共纳入6 个RCT 进行分析。由于纳入的研究所提供的数据提供不充分，未进行合并分析。6 篇文献质量均为B 级。研究结果显示格列美脲组降低2 型糖尿病患者糖化血红蛋白、空腹和餐后血糖，以及提高餐后血浆胰岛素的效果与安慰剂组比较，其差异有统计学意义（P lt;0.05）。3 个研究报道格列美脲组与安慰剂组比较，对空腹血浆胰岛素（FI）的影响，两组差异有统计学意义（P lt;0.05），而1 个研究显示两组差异无统计学意义（P gt;0.05）。6 个RCT 结果均提示格列美脲不良反应轻微。
结论　基于当前证据，格列美脲能降低2 型糖尿病患者的糖化血红蛋白、空腹和餐后血糖，提高空腹和餐后血浆胰岛素，且不良反应轻微，是治疗2 型糖尿病的有效又安全的磺脲类药物。

引用本文： 柳汝明,贾萍,唐尧. 格列美脲治疗2型糖尿病有效性及安全性系统评价. 中国循证医学杂志, 2009, 09(10): 1094-1098. doi: 10.7507/1672-2531.20090193 复制

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8.	Roberts VL, Stewart J, Issa M, et al. Triple therapy with glimepiride in patients with type 2 diabetes mellitus inadequately controlled by metformin and a thiazolidinedione: results of a 30-week, randomized, double-blind, placebo-controlled, parallel-group study. Clin Ther, 2005, 27(10): 1535-1547.
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13.	Goldberg RB, Holvey SM, Schneider J. A dose-response study of glimepiride in patients with NIDDM who have previously received sulfonylurea agents. The Glimepiride Protocol #201 Study Group. Diabetes Care, 1996, 19(8): 849-856.
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1. International Diabetes Federation. Diabetes Atlas (third edition). 2007.
2. 叶任高, 陆再英. 内科学. 第6版. 北京: 人民卫生出版社, 2006, 787.
3. 吴桢, 周树娥. 目前临床评价最优的磺脲类降糖药—格列美脲. 实用糖尿病杂志, 2008, 4(6): 54-55.
4. 叶任高, 陆再英. 内科学. 第6版. 北京: 人民卫生出版社, 2006, 797.
5. American Diabetes Association: The pharmacological treatment of hyperglycemia in NIDD-M. Diabetes Care, 1995, 18(11): 1510-1518.
6. American Diabetes Association: Guide to diagnosis and classification of diabetes mellitus and other categories of glucose intolerance (Position Statement). Diabetes Care, 1997, 20(Suppl. 1): S21.
7. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of Randomized clinical trials: is blinding necessary? Control Clin Trials, 1996, 17(1): 1-12.
8. Roberts VL, Stewart J, Issa M, et al. Triple therapy with glimepiride in patients with type 2 diabetes mellitus inadequately controlled by metformin and a thiazolidinedione: results of a 30-week, randomized, double-blind, placebo-controlled, parallel-group study. Clin Ther, 2005, 27(10): 1535-1547.
9. Madsbad S, Schmitz O, Ranstam J, et al. Improved glycemic control with no weight increase in patients with type 2 diabetes after oncedaily treatment with the long-acting glucagon-like peptide 1 analog liraglutide (NN2211). Diabetes Care, 2004, 27(6): 1335-1342.
10. Luis Bautista J, Bugos C, Dirnberger G, et al. Efficacy and safety profile of glimepiride in Mexican American Patients with type 2 diabetes mellitus: a randomized， placebo-controlled study. clinical therapeutics, 2003, 25(1): 194-209.
11. DS Schade, L Jovanovic, J Schneider. A placebo-controlled, randomized study of glimepiride in patients with type 2 diabetes mellitus for whom diet therapy is unsuccessful. the journal of Clinical Pharmacology, 1998, 38(7): 636-641.
12. Rosenstock J, Samols E, Muchmore DB, et al. Glimepiride, a new once-daily sulfonylurea. A double-blind placebo-controlled study of NIDDM patients. Diabetes Care, 1996, 19(11): 1194-1199.
13. Goldberg RB, Holvey SM, Schneider J. A dose-response study of glimepiride in patients with NIDDM who have previously received sulfonylurea agents. The Glimepiride Protocol #201 Study Group. Diabetes Care, 1996, 19(8): 849-856.
14. Vickers A, Goyal N, Harland R, et al. Do certain countries produce only positNe results? A systematic review of controlled trials. Control Clin Trials, 1998, 19(2): 159-166.

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《中国循证医学杂志》

格列美脲治疗2型糖尿病有效性及安全性系统评价

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《中国循证医学杂志》

格列美脲治疗2型糖尿病有效性及安全性系统评价

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