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目的:系统评价阿卡波糖治疗糖耐量损伤(IGT)的疗效,以为临床治疗提供循证参考。方法:计算机检索Medline、Cochrane图书馆、Pub Med、EMBase、维普数据库、中国期刊全文数据库、万方数据库,收集阿卡波糖(试验组)对比安慰剂(对照组)治疗IGT的随机对照试验(RCT),提取资料并评价质量后,采用Rev Man 5.0统计软件进行Meta分析。结果:共纳入26项RCT,合计2 221例患者。Meta分析结果显示,试验组患者空腹血糖水平[WMD=-0.76,95%CI(-0.99,-0.53),P<0.001]、餐后2 h血糖水平[WMD=-1.58,95%CI(-1.82,-1.34),P<0.001]、糖化血红蛋白水平[WMD=-0.46,95%CI(-0.82,-0.11),P=0.01]、体质量指数[WMD=-1.10,95%CI(-1.77,-0.44),P=0.001]、总胆固醇水平[WMD=-0.35,95%CI(-0.59,-0.12),P=0.003]、甘油三酯水平[WMD=-0.30,95%CI(-0.44,-0.16),P<0.001]均显著低于对照组,而高密度脂蛋白水平[WMD=-0.05,95%CI(-0.11,0.01),P=0.11]和低密度脂蛋白水平[WMD=-0.13,95%CI(-0.31,0.05),P=0.17]与对照组比较差异无统计学意义。结论:阿卡波糖治疗IGT疗效较好。由于纳入研究质量不高,该结论有待大样本、高质量的RCT进一步验证。
Objective: To systematically evaluate the curative effect of acarbose on impaired glucose tolerance (IGT) in order to provide evidence-based reference for clinical treatment. Methods: The randomized controlled trials (IGT) of acarbose (placebo group) and placebo (control group) were collected from Medline, Cochrane Library, Pub Med, EMBase, VIP database, Chinese Journal Full- RCT). After extracting the data and evaluating the quality, Meta-analysis was performed using RevMan 5.0 statistical software. Results: A total of 26 RCTs were included, totaling 221l patients. The results of Meta-analysis showed that the fasting blood glucose level in the test group was significantly higher than that of the control group (WMD = -0.76, 95% CI -0.99, -0.53, P <0.001) 1.82, -1.34), P <0.001], HbA1c (WMD = -0.46,95% CI -0.82, -0.11), P = 0.01] and body mass index [WMD = -1.10,95% CI 1.77, -0.44), P = 0.001], total cholesterol levels [WMD = -0.35,95% CI (-0.59, -0.12), P = 0.003], triglyceride levels [WMD = -0.30, 95% CI -0.44, -0.16), P <0.001] were significantly lower than those in the control group, but the levels of HDL [WMD = -0.05,95% CI (-0.11,0.01), P = 0.11] and the level of low density lipoprotein [WMD = -0.13, 95% CI (-0.31, 0.05), P = 0.17] There was no significant difference compared with the control group. Conclusion: Acarbose treatment of IGT better effect. Due to the poor quality of the included studies, this conclusion needs to be validated by a large sample of high quality RCTs.