摘要
目的评价艾司西酞普兰联合奥氮平治疗抑郁症的效果及安全性,以期为抑郁症治疗方案的选择提供参考。方法计算机检索中国知网、万方、维普、超星读秀、中国生物医学文献数据库(CBM)、PubMed、Web Of Science、Cochrane Library数据库中相关文献,按纳入与排除标准筛选文献、提取资料并评价偏倚风险后,采用Revman 5.3进行Meta分析。结果共纳入16篇随机对照研究,包括1300例患者。Meta分析结果显示,艾司西酞普兰联合奥氮平组与单用艾司西酞普兰组的终点总有效率(RR=1.16,95%CI:1.05~1.28,P=0.004)和终点痊愈率(RR=1.91,95%CI:1.58~2.31,P<0.01)均有统计学意义。治疗4周(SMD=-0.95,95%CI:-1.28^-0.62,P<0.01)和治疗8周后(SMD=-1.53,95%CI:-1.84^-1.22,P<0.01),两组HAMD评分差异有统计学意义。艾司西酞普兰联合奥氮平组体质量增加(RR=6.21,95%CI:3.37~11.45,P<0.01)及嗜睡(RR=4.26,95%CI:2.17~8.36,P<0.01)发生率较单用艾司西酞普兰组高。结论艾司西酞普兰联合奥氮平治疗较单用艾司西酞普兰治疗对抑郁症的效果可能更好,但可能出现体质量增加及嗜睡的发生。
Objective To evaluate the efficacy and safety of escitalopram combined with olanzapine in the treatment of depression,so as to provide references for the selection of treatment programs for depression.Methods Randomized controlled trials(RCTs)about the treatment published in foreign and domestic databases,including CNKI,Wanfang Data,VIP database,Duxiu database,China Biology Medicine database(CBM),PubMed,Web Of Science and Cochrane Library were retrieved.After screening the literature according to inclusion and exclusion criteria,extracting the data and evaluating the risk of bias,Revman 5.3 was used for Meta-analysis.Results A total of 16 RCTs involving 1300 patients were included.The results of Meta-analysis showed that the final effective rate(RR=1.16,95%CI:1.05~1.28,P=0.004)and final healing rate(RR=1.91,95%CI:1.58~2.31,P<0.01)of the escitalopram combined with olanzapine group and the escitalopram group alone were statistically significant.After treatment for 4 weeks(SMD=-0.95,95%CI:-1.28^-0.62,P<0.01)and 8 weeks(SMD=-1.53,95%CI:-1.84^-1.22,P<0.01),the differences in HAMD scores between the two groups were statistically significant.The incidence of weight gain(RR=6.21,95%CI:3.37~11.45,P<0.01)and drowsiness(RR=4.26,95%CI:2.17~8.36,P<0.01)of escitalopram combined with olanzapine group were higher than those of the escitalopram group alone.Conclusion Escitalopram combined with olanzapine may have a better efficacy on depression than escitalopram monotherapy,but combination therapy may result in increased weight gain and drowsiness.
作者
葛祥丽
李慧敬
崔明湖
东莹莹
Ge Xiangli;Li Huijing;Cui Minghu;Dong Yingying(Clinical Medical College of Binzhou Medical University,Binzhou Medical University Hospital,Binzhou 256600,China)
出处
《四川精神卫生》
2019年第6期523-530,共8页
Sichuan Mental Health
