目的:觀察辛伐他汀、吡格列酮和苯磺酸左旋氨氯地平聯合治療代謝綜合征療效。方法:76例初診代謝綜合征患者,服用吡格列酮15mg/d、苯磺酸左旋氨氯地平25mg/d、辛伐他汀10mg/d,療程1個月。觀察治療前后血壓、腰圍、體重指數、血糖、血胰島素、血尿酸和血脂水平等變化。結果:患者治療后血糖、血脂、胰島素水平、血壓均明顯降低,差別有統計學意義(Plt;001)。腰圍、體重指數略有下降,無統計學意義,血尿酸變化不明顯。結論:吡格列酮、辛伐他汀和苯磺酸左旋氨氯地平聯合治療代謝綜合征能夠改善胰島素抵抗和代謝異常,療效可靠、服藥簡單、依從性好,效價比合理,無不良反應。
Objective To assess the efficacy and safety of levoamlodipine besylate for essential hypertension. Methods We searched MEDLINE (1999 to October 2007), EMBASE (1999 to October 2007), The Cochrane Library (Issue 3, 2007), CNKI (1999 to 2007), Wanfang (1999 to 2007), VIP (1999 to 2007) and CBM (1999 to October 2007). The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration’ s RevMan 4.2 software. Results A total of 345 articles were retrieved, but only 17 were finally included. Meta-analyses showed that the effective rate in patients receiving levoamlodipine besylate was significantly higher than that in patients receiving indapamide (RD 0.14, 95%CI 0.06 to 0.22, P=0.0004), while no significant differences were noted between the levoamlodipine besylate group and other control groups. The incidence of adverse effects was significantly lower in the levoamlodipine besylate group compared to the indapamide group (RD –0.12, 95%CI –0.21 to –0.03, P=0.01), the amlodipine group (RD –0.06, 95%CI –0.11 to –0.01, P=0.02) and the nitrendipine group (RD –0.27, 95%CI –0.46 to –?0.08, P=0.006). No significant differences were observed between the levoamlodipine besylate group and other control groups. Conclusion Levoamlodipine besylate tends to have better efficacy and safety profiles compared with other antihypertensive drugs. However, most trials included in the review were of poor quality and, so, multi-center large-scale randomized controlled trials of higher quality are needed to confirm this.