摘要
目的:评估药学干预对2型糖尿病患者治疗效果的影响。方法:检索Pub Med、Embase、Cochrane Library、Web of Science、CNKI、万方、维普、Sino Med等中英文数据库,检索时间为建库起至2023年12月31日,收集药师参与2型糖尿病患者治疗方案的随机对照试验(Randomized Contrdled Trial,RCT),进行质量评价并提取文献有效数据,应用Rev Man 5.3软件进行Meta分析。结果:纳入27篇RCT,共计5100例患者。Meta分析结果显示:有效性方面,药学干预可降低患者糖化血红蛋白[MD=-1.04,95%CI(-1.28,-0.80),P<0.001]、空腹血糖[MD=-1.66,95%CI(-1.97,-1.35),P<0.001]、餐后2 h血糖[MD=-2.24,95%CI(-2.99,-1.50),P<0.001]、收缩压[MD=-6.17,95%CI(-8.74,-3.60),P<0.001]、舒张压[MD=-2.59,95%CI(-4.16,-1.03),P=0.001]、总胆固醇[MD=-10.11,95%CI(-15.51,-4.71),P<0.001]、低密度脂蛋白胆固醇[MD=-8.53,95%CI(-13.29,-3.78),P<0.001]等指标,差异均有统计学意义;药学干预还可降低患者再入院率[RR=0.58,95%CI(0.44,0.75),P<0.001],提高患者疾病知识水平[MD=3.36,95%CI(2.56,4.16),P<0.001],差异均有统计学意义;但对降低患者体质量、甘油三酯,提高生活质量、满意度和高密度脂蛋白胆固醇等方面(P>0.005),差异均无统计学意义。依从性方面,药学干预可提高患者的用药依从性,差异有统计学意义[MD=2.96,95%CI(1.57,4.35),P<0.001]。安全性方面,药学干预可显著降低患者不良反应发生率[RR=0.58,95%CI(0.48,0.70),P<0.001],差异有统计学意义。结论:药学干预可显著降低患者的血糖、血压和部分血脂水平以及再入院率,提高患者的用药依从性和疾病知识水平,同时可降低再入院率和不良反应发生率,体现了药师参与2型糖尿病患者治疗方案的积极价值。
Objective:Evaluating the impact of pharmacy interventions on outcomes in patients with type 2 diabetes mellitus.Methods:Chinese and English databases such as PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,Wipro,SinoMed,etc.were searched from the time of library construction to 31 December 2023,and RCT of pharmacists'participation in the treatment protocols for patients with type 2 diabetes mellitus were collected for quality assessment and after extracting valid data from the literature,RevMan 5.3 software was applied to perform Meta-analysis.Results:27 RCTs with a total of 5100 patients were included.Meta-analysis results showed that,in terms of effectiveness,pharmacological interventions reduced patients'glycated haemoglobin[MD=-1.04,95%CI(-1.28,-0.80),P<0.001],fasting blood glucose[MD=-1.66,95%CI(-1.97,-1.35),P<0.001],postprandial 2 h blood glucose[MD=-2.24,95%CI(-2.99,-1.50),P<0.001],systolic blood pressure[MD=-6.17,95%CI(-8.74,-3.60),P<0.001],diastolic blood pressure[MD=-2.59,95%CI(-4.16,-1.03),and P=0.001],total cholesterol[MD=-10.11,95%CI(-15.51,-4.71),P<0.001],and low-density lipoprotein cholesterol[MD=-8.53,95%CI(-13.29,-3.78),P<0.001].The differences were statistically significant,the pharmacological intervention also reduced the readmission rate of patients[RR=0.58,95%CI(0.44,0.75),P<0.001],and improve patients'knowledge of the disease[MD=3.36,95%CI(2.56,4.16),P<0.001],and the differences were statistically significant.However,it had a significant effect on lowering the patients'body mass and triglycerides,and improving the quality of life,satisfaction,and HDL-cholesterol aspects(P>0.05),the differences were not statistically significant.In terms of adherence,pharmacy intervention could improve patients'medication adherence,and the difference was statistically significant[MD=2.96,95%CI(1.57,4.35),P<0.001].In terms of safety,pharmacy intervention significantly reduced the incidence of adverse reactions in patients[RR=0.58,95%CI(0.48,0.70),P<0.001],and the difference was statistically significant.Conclusions:Pharmacy interventions can significantly reduce patients'blood glucose,blood pressure,and some lipid levels,as well as readmission rates,and improve medication adherence and disease knowledge,while reducing readmission rates and the incidence of adverse events,demonstrating the positive value of pharmacist involvement in the treatment regimen of patients with type 2 diabetes mellitus.
作者
岳江红
智勇刚
王恒
张静
张选明
彭曦
YUE Jianghong;ZHI Yonggang;WANG Heng;ZHANG Jing;ZHANG Xuanming;PENG Xi(School of Pharmacy,Shihezi University,Shihezi,Xinjiang 832003,China;Department of Pharmacy,the First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 833208,China;Department of Pharmacy,Seventh Division Hospital of Xinjiang Production and Construction Corps,Kuitun,Xinjiang 833211,China;Department of Traditional Chinese Medicine,the First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 832008,China)
出处
《农垦医学》
2025年第4期318-327,共10页
Journal of Nongken Medicine
基金
新疆生产建设兵团重大科技项目(2020AA005)。
关键词
2型糖尿病
药学干预
META分析
Type 2 diabetes mellitus
Pharmacy intervention
Meta-analysis
