[1]付林杰,苏海玉,李海志.sglt2抑制剂联合二甲双胍治疗二型糖尿病的Meta分析[J].医学信息,2025,38(01):49-54.[doi:10.3969/j.issn.1006-1959.2025.01.008]
　FU Linjie,SU Haiyu,LI Haizhi.Meta-analysis of sglt2 Inhibitor Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus[J].Journal of Medical Information,2025,38(01):49-54.[doi:10.3969/j.issn.1006-1959.2025.01.008]
点击复制

sglt2抑制剂联合二甲双胍治疗二型糖尿病的Meta分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年01期
页码:
49-54
栏目:
医学数据科学
出版日期:
2025-01-01

文章信息/Info

Title:
Meta-analysis of sglt2 Inhibitor Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus
文章编号:
1006-1959（2025）01-0049-06
作者:
付林杰1; 苏海玉2; 李海志1
1.云南省阜外心血管病医院/昆明医科大学附属心血管病医院药剂科，云南 昆明 650102；2.昆明医科大学药学院，云南 昆明 65050
Author(s):
FU Linjie1;  SU Haiyu2;  LI Haizhi1
1.Department of Pharmacy, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences/Affilated Cardiovascular Hospital of Kunming Medical University, Kunming 650102, Yunnan, China;2.School of Pharmacy, Kunming Medical University, Kunming 650500, Yunnan, China
关键词:
sglt2抑制剂; 二甲双胍; T2DM
Keywords:
sglt2 inhibitor;  Metformin;  T2DM
分类号:
R587.1
DOI:
10.3969/j.issn.1006-1959.2025.01.008
文献标志码:
A
摘要:
目的 系统评价在单一药物治疗二型糖尿病（T2DM）疗效不佳的情况下使用钠-葡萄糖协同转运蛋白2（sglt2）抑制剂和二甲双胍联合治疗的有效性，为临床用药提供循证参考。方法 计算机检索PubMed、Embase、Medline、CBM、中国知网（CNKI）、维普（VIP）、万方（Wangfang data）数据库有关sglt2抑制剂联合二甲双胍（观察组）对比其他任意两种药物（对照组）治疗T2DM疗效的文献，检索时间从建库至2022年12月31日。采用RevMan5.3软件进行Meta分析，漏斗图进行偏倚分析。结果 最终纳入17篇文献，共3431例患者，Meta分析结果显示，观察组空腹血糖值（MD=-0.48，95%CI=-0.76~-0.19，P=0.001）、餐后2 h血糖值（MD=-0.41，95%CI=-0.67~-0.14，P=0.003）、糖化血红蛋白值（MD=-0.53，95%CI=-0.78~-0.28，P＜0.000 01）优于对照组。结论 sglt2抑制剂联用二甲双胍在单一药物治疗不佳的情况下治疗T2DM效果理想，且均未发生严重不良反应。
Abstract:
Objective To systematically evaluate the efficacy of sodium-glucose cotransporter 2 (sglt2) inhibitors combined with metformin in the treatment of type 2 diabetes mellitus (T2DM) with poor efficacy of single drug, and to provide evidence-based reference for clinical medication. Methods PubMed, Embase, Medline, CBM, China National Knowledge Infrastructure (CNKI), VIP and Wangfang data databases were searched by computer for the literature on the efficacy of sglt2 inhibitor combined with metformin (observation group) compared with any other two drugs (control group) in the treatment of T2DM from the establishment of the database to December 31, 2022. Meta-analysis was performed using RevMan5.3 software, and funnel plot was used for bias analysis. Results A total of 17 articles were included, involving 3431 patients. The results of meta-analysis showed that the fasting blood glucose (MD=-0.48, 95%CI=-0.76 to -0.19, P=0.001), 2 h postprandial blood glucose (MD=-0.41, 95%CI=-0.67 to -0.14, P=0.003) and glycosylated hemoglobin (MD=-0.53, 95%CI=-0.78 to -0.28, P<0.000 01) in the observation group were better than those in the control group. Conclusion sglt2 inhibitor combined with metformin is effective in the treatment of T2DM with poor single drug treatment, and no serious adverse reactions occur.

参考文献/References:

[1]刘烨,王海宁.2021年ADA/EASD《糖尿病缓解专家共识》与《2022年ADA糖尿病指南：2型糖尿病的预防和治疗中肥胖与体重管理》解读——糖尿病缓解的定义与治疗策略[J].临床内科杂志,2022,39(5):299-302.[2]孙琦超.胰岛素抵抗评价指标与2型糖尿病患者亚临床左心室功能障碍的相关性研究[D].北京:北京协和医学院,2023.[3]杨雁,余学锋.从指南更新看二甲双胍在2型糖尿病药物治疗中的地位[J].中国实用内科杂志,2022,42(11):884-888.[4]赵维纲.《中国老年2型糖尿病防治临床指南(2022年版)》解读[J].协和医学杂志,2022,13(4):574-580.[5]Ahmed I,Raja UY,Wahab MU,et al.Efficacy and safety of combination of empagliflozin and metformin with combination of sitagliptin and metformin during Ramadan: an observational study[J].BMC Endocr Disord,2022,22(1):247.[6]Rosenstock J,Hansen L,Zee P,et al.Dual add-on therapy in type 2 diabetes poorly controlled with metformin monotherapy: a randomized double-blind trial of saxagliptin plus dapagliflozin addition versus single addition of saxagliptin or dapagliflozin to metformin[J].Diabetes Care,2015,38(3):376-383.[7]Kitazawa M,Katagiri T,Suzuki H,et al.A 52-week randomized controlled trial of ipragliflozin or sitagliptin in type 2 diabetes combined with metformin: The N-ISM study[J].Diabetes Obes Metab,2021,23(3):811-821.[8]Romera I,Gomis R,Crowe S,et al.Empagliflozin in combination with oral agents in young and overweight/obese Type 2 diabetes mellitus patients: A pooled analysis of three randomized trials[J].J Diabetes Complications,2016,30(8):1571-1576.[9]丰敏可.达格列净与吡格列酮联合二甲双胍治疗2型糖尿病的疗效及对胰岛素敏感性和胰岛α和β细胞功能的影响[J].医药论坛杂志,2022,43(4):93-96.[10]卢敏江.利拉鲁肽、达格列净分别联合二甲双胍治疗初发2型糖尿病的临床对比研究[J].实用糖尿病杂志,2020,16(5):124-125.[11]唐平,孙致连,程筱玲,等.达格列净或阿卡波糖联合二甲双胍对初诊2型糖尿病患者血糖波动的影响比较[J].药物流行病学杂志,2022,31(7):435-438.[12]宋金方,张亮,林维娜,等.达格列净或西格列汀联合二甲双胍治疗2型糖尿病的疗效对比研究[J].实用药物与临床,2019,22(3):253-255.[13]张燕,周婷婷,李万红.SGLT2抑制剂+二甲双胍对2型糖尿病患者血糖控制及BMI的影响[J].慢性病学杂志,2021,22(12):1907-1908,1911.[14]朱瑾英,王尚农,刘泮力.GLP1受体激动剂和SGLT2抑制剂分别联合二甲双胍治疗2型糖尿病的疗效对比[J].河北医学,2022,28(7):1213-1218.[15]李葵,刘兆云,李康.达格列净和西格列汀对单用二甲双胍血糖控制不佳2型糖尿病患者内脏脂肪含量的影响[J].中国药物经济学,2022,17(3):111-114.[16]毋飞飞,汪凌霄.卡格列净片和阿卡波糖胶囊分别联合二甲双胍治疗糖尿病的临床效果[J].中国卫生检验杂志,2022,32(17):2119-2122.[17]Sudan A,Kalra A,Mirza AA,et al.Efficacy of DPP-4 inhibitors and SGLT2 inhibitors compared to sulphonylureas in adult patients with diabetes with low c-peptide levels with or without anti-GAD65 antibody positivity[J].Diabetes Metab Syndr,2021,15(4):102197.[18]Müller-Wieland D,Kellerer M,Cypryk K,et al.Efficacy and safety of dapagliflozin or dapagliflozin plus saxagliptin versus glimepiride as add-on to metformin in patients with type 2 diabetes[J].Diabetes Obes Metab,2018,20(11):2598-2607.[19]Lingvay I,Catarig AM,Frias JP,et al.Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial[J].Lancet Diabetes Endocrinol,2019,7(11):834-844.[20]Pratley RE,Eldor R,Raji A,et al.Ertugliflozin plus sitagliptin versus either individual agent over 52 weeks in patients with type 2 diabetes mellitus inadequately controlled with metformin: The VERTIS FACTORIAL randomized trial[J].Diabetes Obes Metab,2018,20(5):1111-1120.[21]Dagogo-Jack S,Liu J,Eldor R,et al.Efficacy and safety of the addition of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin and sitagliptin: The VERTIS SITA2 placebo-controlled randomized study[J].Diabetes Obes Metab,2018,20(3):530-540.

相似文献/References:

[1]刘朝阳,张善革.二甲双胍单药及不同联合用药方案治疗2型糖尿病的随机对照研究[J].医学信息,2019,32(04):148.[doi:10.3969/j.issn.1006-1959.2019.04.048]
　LIU Chao-yang,ZHANG Shan-ge.A Randomized Controlled Trial of Metformin Monotherapy and Different Combination Regimens in the Treatment of Type 2 Diabetes[J].Journal of Medical Information,2019,32(01):148.[doi:10.3969/j.issn.1006-1959.2019.04.048]
[2]苗 婷,刘子艳,刘玉媛,等.二甲双胍药理作用及其机制研究[J].医学信息,2019,32(14):53.[doi:10.3969/j.issn.1006-1959.2019.14.018]
　MIAO Ting,LIU Zi-yan,LIU Yu-yuan,et al.Study on Pharmacological Action and Mechanism of Metformin[J].Journal of Medical Information,2019,32(01):53.[doi:10.3969/j.issn.1006-1959.2019.14.018]
[3]金 川,张 颖,李瑞环,等.葛根芩连汤对2型糖尿病患者糖脂代谢指标及 体重的影响[J].医学信息,2019,32(14):164.[doi:10.3969/j.issn.1006-1959.2019.14.055]
　JIN Chuan,ZHANG Ying,LI Rui-huan,et al.Effect of Gegen Qinlian Decoction on Glucose and Lipid Metabolism Index and Body Weight in Patients with Type 2 Diabetes Mellitus[J].Journal of Medical Information,2019,32(01):164.[doi:10.3969/j.issn.1006-1959.2019.14.055]
[4]尤 丽,卢 琦.甘精胰岛素联合二甲双胍治疗2型糖尿病的疗效[J].医学信息,2020,33(02):151.[doi:10.3969/j.issn.1006-1959.2020.02.046]
　YOU Li,LU Qi.Effect of Insulin Glargine Combined with Metformin in the Treatment of Type 2 Diabetes[J].Journal of Medical Information,2020,33(01):151.[doi:10.3969/j.issn.1006-1959.2020.02.046]
[5]王海燕,毕雪玲,曹 晶,等.坤泰胶囊联合炔雌醇环丙孕酮片、二甲双胍治疗多囊卵巢综合征的效果及对性激素的影响[J].医学信息,2020,33(20):129.[doi:10.3969/j.issn.1006-1959.2020.20.039]
　WANG Hai-yan,BI Xue-ling,CAO Jing,et al.The Effect of Kuntai Capsule Combined with Ethinyl Estradiol and Cyproterone Tablets and Metformin in the Treatment of Polycystic Ovary Syndrome and Its Influence on Sex Hormones[J].Journal of Medical Information,2020,33(01):129.[doi:10.3969/j.issn.1006-1959.2020.20.039]
[6]张月田,刘世平.二甲双胍治疗2型糖尿病的不良反应及联合用药的应用[J].医学信息,2021,34(06):64.[doi:10.3969/j.issn.1006-1959.2021.06.017]
　ZHANG Yue-tian,LIU Shi-ping.Adverse Reactions of Metformin in the Treatment of Type 2 Diabetes and the Application of Combined Medication[J].Journal of Medical Information,2021,34(01):64.[doi:10.3969/j.issn.1006-1959.2021.06.017]
[7]徐晨曦.达格列净联合DPP-4抑制剂与二甲双胍对血糖控制不佳2型糖尿病患者血糖及脂代谢的影响[J].医学信息,2022,35(09):165.[doi:10.3969/j.issn.1006-1959.2022.09.042]
　XU Chen-xi.Effects of Daglitazone Combined with DPP-4 Inhibitor and Metformin on Blood Glucose and Lipid Metabolism in Patients with Type 2 Diabetes Mellitus with Poor Glycemic Control[J].Journal of Medical Information,2022,35(01):165.[doi:10.3969/j.issn.1006-1959.2022.09.042]
[8]范卢明,王 慧,薛 帆,等.缬沙坦联合二甲双胍治疗肥胖型高血压效果的Meta分析[J].医学信息,2022,35(15):68.[doi:10.3969/j.issn.1006-1959.2022.15.014]
　FAN Lu-ming,WANG Hui,XUE Fan,et al.Meta-analysis of the Effect of Valsartan Combined with Metformin in the Treatment of Obese Hypertension[J].Journal of Medical Information,2022,35(01):68.[doi:10.3969/j.issn.1006-1959.2022.15.014]
[9]房 芳,于 宏.利拉鲁肽联合二甲双胍治疗2型糖尿病的疗效观察[J].医学信息,2022,35(16):141.[doi:10.3969/j.issn.1006-1959.2022.16.036]
　FANG Fang,YU Hong.Effect of Liraglutide Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus[J].Journal of Medical Information,2022,35(01):141.[doi:10.3969/j.issn.1006-1959.2022.16.036]
[10]孙 铎,张秀珍,邓晓君.不同剂量二甲双胍联合磷酸西格列汀治疗2型糖尿病患者的临床疗效及安全性观察[J].医学信息,2023,36(09):135.[doi:10.3969/j.issn.1006-1959.2023.09.028]
　SUN Duo,ZHANG Xiu-zhen,DENG Xiao-jun.Clinical Efficacy and Safety of Different Doses of Metformin Combined with Sitagliptin Phosphate in the Treatment of Patients with Type 2 Diabetes Mellitus[J].Journal of Medical Information,2023,36(01):135.[doi:10.3969/j.issn.1006-1959.2023.09.028]

更新日期/Last Update: 1900-01-01