循证作业课件资料

1、二甲双胍控制不良的二型糖尿病人应用格列美脲和西他列汀的疗效和安全性比较二甲双胍不给力？选格列美脲还是西他列汀？问题词根:sitagliptin glimepiride疾病:type 2 diabetes检索结果：R. Arechavaleta1, T. Seck2, Y. Chen2, K. J. Krobot3, E. A. ONeill2, L. Duran2, K. D. Kaufman2, D. Williams-Herman2 & B. J.Goldstein2Efficacy and safety of treatment with sitagliptin or glimepiri

2、de in patients with type 2 diabetes inadequately controlled on metformin monotherapy: a randomized, double-blind, non-inferiority trialDiabetes, Obesity and Metabolism 13: 160168, 2011Methods: Patients with type 2 diabetes and an HbA1c of 6.59.0% while on a stable dose of metformin (1500 mg/day) com

3、bined with diet and exercise for at least 12 weeks were randomized in a double-blind manner to receive either sitagliptin 100 mg daily (N = 516) or glimepiride (starting dose 1 mg/day and up-titrated, based upon patients self-monitoring of blood glucose results, to a maximum dose of up to 6 mg/day)

4、(N = 519) for 30 weeks. The primary analysis assessed whether sitagliptin is non-inferior to glimepiride in reducing HbA1c at week 30 (based on the criterion of having an upper bound of the 95% CI less than the prespecified non-inferiority bound of 0.4%).Result：分析评价真实性1.严格的筛选病人，计算机随机分配。2.基线一致3. 1035

5、名受访者，936名完成，两组均达到90%以上，时间30周4.936名完成者均符合实验要求，不存在没有服药或是接受了错误治疗。5.双盲。6.不存在不符合实验的其他影响实验结果的辅助治疗及其他。一直以来，二甲双胍和磺酰类药物作为治疗糖尿病的一线药物，而当二甲双胍单独治疗血糖控制不理想，磺酰类的副作用又比较明显的情况下，是否可以选择其他副作用较小但疗效又相当的药物？相对危险降低率RRR=59.4%CER=22.4% EER=9.1%绝对危险降低率ARR=CER-EER=13.3%NNT=1/ARR=8实用性1.研究对象（纳入标准为age18）大部分是白种人和亚裔，但白种人占比重较大，代表性不是很强。2