目的 系統(tǒng)評(píng)價(jià)二甲雙胍聯(lián)合氨氯地平治療肥胖型高血壓的療效與不良反應(yīng)。方法 使用關(guān)鍵詞檢索Cochrane library、PubMed、EMbase、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、中國(guó)生物醫(yī)學(xué)全文數(shù)據(jù)庫(kù)（CBM）、萬(wàn)方數(shù)據(jù)庫(kù)，收集以二甲雙胍聯(lián)合氨氯地平（治療組）相較于單用氨氯地平（對(duì)照組）治療肥胖型高血壓的隨機(jī)對(duì)照試驗(yàn)（RCT），用RevMan 5.0軟件進(jìn)行Meta學(xué)分析，比較兩組在降壓、改善血糖及血脂水平方面的差異及安全性。結(jié)果 共納入15個(gè)RCT，計(jì)1 389例患者。Meta分析結(jié)果顯示：二甲雙胍聯(lián)合氨氯地平較單獨(dú)用氨氯地平更能有效地降低肥胖型高血壓患者的血壓[RR=1.22，95%CI（1.14，1.29）]，且聯(lián)合用藥組能有效改善空腹血糖水平[WMD=-0.42 mmol/L，95%CI（-0.69，-0.14）]及糖化血紅蛋白水平[WMD=-0.11 mmol/L，95%CI（-1.81，-0.40）]，兩組不良反應(yīng)發(fā)生率比較無(wú)統(tǒng)計(jì)學(xué)差異[（RR=0.22，95%CI（0.04，1.38）P=0.11]。結(jié)論 肥胖型高血壓患者接受二甲雙胍聯(lián)合氨氯地平治療，較單用氨氯地平能有效地降壓、改善血糖及糖化血紅蛋白水平，而不增加不良反應(yīng)。

Objective To assess the effectiveness and adverse drug reaction of metformin plus amlodipine in patients with obesity related hypertension. Methods Based on the keywords retrieval way, Cochrane Library, PubMed, Embase, China Biomedical Literature Database, China Journal Fulltext Database, and Wanfang database were searched. Randomized controlled trials (RCTs) of metformin plus amlodipine versus amlodipine for obesity related hypertension were included. The quality of the RCTs included were assessed, software RevMan 5.0 was used for Meta-analysis. The differences in blood pressure, glucose and lipid levels were compared between metformin plus amlodipine group and amlodipine group. Results A total of 15 RCTs and 1389 patients were included. Meta analysis showed that the blood pressure[RR=1.22, 95%CI(1.14, 1.29)] was more effectively reduced, and fasting plasma glucose levels[WMD=-0.42 mmol/L, 95%CI(-0.69, -0.14)] and HbA1c levels[WMD=-0.11 mmol/L, 95%CI(-1.81, -0.40)] were improved significantly with metformin plus amlodipine therapy. Furthermore, there was no significant difference in the incidence of adverse reaction between two groups[(RR=0.22, 95%CI(0.04, 1.38, P=0.11)]. Conclusion Current evidence demonstrates that combination treatment with metformin plus amlodipine improve blood glucose level, HbA1c level and attenuate blood pressure more effectively without increasing the adverse reaction.

國(guó)家青年自然科學(xué)基金（81603099）；上海市高校優(yōu)秀青年教師科研基金（zzjdyx12089）