世界中医药
文章摘要
引用本文:聂春丽1,李靖2,郑世静3,蒋逸韵4.中西医结合治疗2型糖尿病胰岛素抵抗的Meta分析[J].世界中医药,2018,(03):.  
中西医结合治疗2型糖尿病胰岛素抵抗的Meta分析
Systematic Review and Meta-analysis of Integrated Traditional Chinese and Western Medicine in the Treatment of Type 2 Diabetes Insulin Resistance
投稿时间:2017-06-08  
DOI:10.3969/j.issn.1673-7202.2018.03.056
中文关键词:  中西医  西医  2型糖尿病  胰岛素抵抗  临床疗效  优势  随机对照试验  系统评价  Meta分析
English Keywords:Chinese and western medicine  Western medicine  Type 2 diabetes  Insulin resistance  Clinical effect  Advantages  Randomized controlled trials  Systematic review  Meta-analysis
基金项目:国家中医药管理局2015年度国家中医临床研究研究基地业务建设科研专项课题(JDZX2015136)
作者单位
聂春丽1,李靖2,郑世静3,蒋逸韵4 1 北京中医药大学北京100029 2 北京中医药大学东直门医院北京100700 
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中文摘要:
      目的:系统评价中西医结合治疗2型糖尿病胰岛素抵抗的疗效。方法:应用计算机检索2006—2016年中国知网、万方数据库、维普数据库、Sinomed、The Cochrane Library数据库,手工检索纳入文献的参考文献,查找有关中西医结合治疗2型糖尿病胰岛素抵抗的随机对照试验(RCT),按纳入和排除标准筛选文献,提取资料和评价纳入研究的方法学质量后,采用RevMan53软件进行Meta分析。共纳入16篇文献,1 253例患者,其中观察组644例,对照组609例,各研究均明确指出基线均衡,具有可比性。结果:Meta分析结果显示,中西医结合治疗2型糖尿病胰岛素抵抗在提高临床疗效(RR=173,95%CI[146,205])、提高胰岛素敏感指数(MD=026,95%CI[022,03])、降低胰岛素抵抗指数(MD=-102,95%CI[-116,-087])、降低体重指数(MD=-078,95%CI[-126,-03])、降低血脂TC:(MD=-057,95%CI[-073,-042]、TG:(MD=-078,95%CI[-126,-030])、LDL-C:SMD=-046,95%CI[-059,-032]、空腹胰岛素(SMD=-069,95%CI[-081,-057])、空腹血糖(MD=-09,95%CI[-109,-07])、糖化血红蛋白(MD=-077,95%CI[-128,-026])等方面优于单纯西药治疗,差异有统计学意义。结论:中西医结合治疗2型糖尿病胰岛素抵抗具有一定的优势,受纳入研究数量和质量的限制,上述结论尚需开展更多高质量的研究予以验证。
English Summary:
      To systematically review the efficacy of the integrated medicine treatment for type 2 diabetes insulin resistance. Methods:Database including CNKI, VIP, Wan Fang, Sinomed and the Cochrane Library from 2006 to 2016 were searched to identify the randomized controlled trials (RCTS) on integrated medicine treatment for type 2 diabetes insulin resistance. According to the inclusion and exclusion criteria, data was screened and extracted, and assessing methodological qauality was included for studies. Then meta-analysis was performed using RevMan53 software. Results:A total of 16 papers involving 1253 patients were included (644 in the treatment group and 609 in the control group). All studies clearly pointed out the baseline were balanced and comparable. Meta-analysis results showed that traditional Chinese and western medicine therapy were superior to convention galgucocorticoid treatment in increasing clinical efficacy (RR=173, 95%CI[146, 205]), increasing insulin sensitivity index (MD=026, 95%CI[022, 03]), lowering insulin resistance index (MD=-102, 95%CI[-116,-087]), BMI (MD=-078, 95%CI[-126,-03]), lowering TC (MD=-057, 95%CI[-073,-042]; TG (MD=-078, 95%CI[-126,-030]), LDL-C:SMD=-046, 95%CI[-059,-032], reducing FINS (SMD=-069, 95%CI[-081,-057]), FBG (MD=-09, 95%CI[-109,-07]), HbA1C (MD=-077, 95%CI[-128,-026]), with statistical significance. Conclusion:The meta-analysis results suggest that the efficacy of the integrated medicine treatment for type 2 diabetes insulin resistance has advantages. Due to limited quantity and quality of the included studies, the above conclusion still needs to be verified by conducting more high quality studies.
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