中国循证医学杂志

中国循证医学杂志

维生素 B1 辅助治疗 2 型糖尿病疗效的 Meta 分析

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目的 系统评价维生素 B1 辅助治疗 2 型糖尿病的疗效。 方法 计算机检索 PubMed、EMbase、The Cochrane Library、CNKI、VIP、WanFang Data 和 CBM 数据库,搜集维生素 B1 辅助治疗 2 型糖尿病的随机对照试验(randomized controlled trials,RCTs),检索时限均为建库至 2017 年 7 月。由 2 位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 RevMan 5.3 和 Stata 12.0 软件进行 Meta 分析。 结果 纳入 6 个 RCTs,共 346 例患者。Meta 分析结果显示,与对照组相比,维生素 B1 辅助组的 C 反应蛋白(CRP)明显改善[MD=–1.09,95%Cl(–1.63,–0.54),P<0.000 1],但在空腹血糖[MD=–0.23,95%Cl(–0.58,0.13),P=0.22]、糖化血红蛋白[MD=0.13%, 95%CI(–0.25,0.52),P=0.49]、2 小时血糖[MD=–0.18,95%CI(–1.03,0.67)P=0.68]、收缩压[MD=2.94,95%Cl(–1.31,7.18),P=0.18]、舒张压[MD=–1.60,95%Cl(–4.24,1.05),P=0.24]、甘油三酯[MD=–0.12,95%Cl(–0.32,0.09),P=0.27]、总胆固醇[MD=0.21,95%Cl(–0.05,0.46),P=0.12]、高密度脂蛋白胆固醇[MD=0.03,95%Cl(–0.07,0.12),P=0.56]、低密度脂蛋白胆固醇[MD=0.12,95%Cl(–0.11,0.35),P=0.30]方面,两组差异均无统计学意义。 结论 当前证据显示,维生素 B1 辅助治疗 2 型糖尿病对患者血糖的控制、血压、血脂的影响并不显著。受纳入研究的数量和质量的限制,上述结论尚待开展更多高质量的研究予以验证。

Objectives To systematically review the therapeutic efficacy of vitamin B1 for adjunctive treatment in type 2 diabetes mellitus. Methods Databases including PubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM were searched to collect randomized controlled trials (RCTs) on vitamin B1 for adjunctive treatment in type 2 diabetes mellitus from inception to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted by RevMan 5.3 and Stata 12.0 softwares. Results A total of 6 RCTs involving 346 patients were included. The results of meta-analysis showed that, compared with the control group, the vitamin B1 adjunctive group had a significant improvement in CRP (MD=–1.09, 95%CI –1.63 to –0.54, P<0.000 1). However, the fasting blood glucose (MD=–0.23, 95%CI –0.58 to 0.13,P=0.22), glycosylated hemoglobin (MD=0.13, 95%CI –0.25 to 0.52, P=0.49), 2 hours plasma glucose (MD=–0.18, 95%CI –1.03 to 0.67, P=0.68), systolic pressure (MD=2.94, 95%CI –1.31 to 7.18, P=0.18), diastolic pressure (MD=–1.60, 95%CI –4.24 to 1.05, P=0.24), triglycerides (MD=–0.12, 95%CI –0.32 to 0.09, P=0.27), total cholesterol (MD=0.21, 95%CI –0.05 to 0.46, P=0.12), high-density lipoprotein cholesterols (MD=0.03, 95%CI –0.07 to 0.12, P=0.56) and low-density lipoprotein cholesterols (MD=0.12, 95%CI –0.11 to 0.35, P=0.30) had no significant differences between both groups. Conclusions Vitamin B1 adjunctive treatment could not improve the levels of blood glucose, blood pressure and serum lipids. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

关键词: 维生素B1; 2型糖尿病; 血糖; 血压; 血脂; C反应蛋白; 随机对照试验; Meta分析

Key words: Vitamin B1; Type 2 diabetes mellitus; Blood glucose; Blood pressure; Serum lipids; CRP; Randomized controlled trial; Meta-analysis

引用本文: 蔺文燕, 姚亮, 张琦, 余静, 王冬冬, 李杨, 李潇, 王百灵, 刘静, 杨克虎. 维生素 B1 辅助治疗 2 型糖尿病疗效的 Meta 分析 . 中国循证医学杂志, 2018, 18(8): 822-830. doi: 10.7507/1672-2531.201710072 复制

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