摘要
目的系统评价无抽搐电休克(Modified Electroconvulsive Therapy,MECT)治疗抑郁症患者的疗效和安全性。方法计算机检索中英文数据库,搜集MECT对抑郁症患者疗效的随机对照试验(Randomized Controlled Trial,RCT),检索时限均从建库至2023年11月,对检索文献进行筛选,依据纳入和排除标准确定最终纳入文献,并对所纳入文献进行质量评价和数据提取,用RevMan 5.3软件对纳入研究进行Meta分析。结果对纳入的9项RCT研究使用随机效应模型进行Meta分析的结果显示,MECT可以显著改善患者的抑郁症状且具有较低异质性[SMD=-0.88,95%CI(-1.09,-0.67),I^(2)=49%,P<0.01],MECT治疗后患者的副反应不显著且具有低异质性[SMD=0.19,95%CI(-0.01,0.4),I^(2)=0,P>0.05]。亚组分析的结果显示,治疗次数在8次及以上、治疗时双颞叶放置改变患者抑郁症状的效果相对更好。结论MECT治疗抑郁症有显著疗效且未增加副反应,安排8次及以上足疗程、双颞叶放置治疗的效果更佳,这一结论的发现具有临床指导意义。
Objective To systematically evaluate the efficacy and safety of Modified Electroconvulsive Therapy(MECT)for depressed patients.Methods A computerized search of Chinese and English databases was conducted to collect Randomized Controlled Trial(RCT)on the efficacy of MECT in patients with depression,with the search time frame ranging from database creation to November 2023.The final included literature was identified based on the inclusion and exclusion criteria,and the included literature was evaluated for quality and extracted,and Meta-analysis was performed on the included studies using RevMan 5.3 software.Results Meta-analysis of the nine included RCT studies using a random-effects model showed that MECT significantly improved patients'depressive symptoms with low heterogeneity[SMD=-0.88,95%CI(-1.09,-0.67),I^(2)=49%,P<0.01],and had no significant side effects on patients with low heterogeneity[SMD=0.19,95%CI(-0.01,0.4),I^(2)=0.P>0.05].The results of the subgroup analysis further showed that the number of treatments at 8 and above and treatment with dual temporal lobe placement comparatively improved the depressive symptoms of the patients.Conclusion MECT has significant efficacy and less side in treating depression,and scheduling 8 and more treatments with dual temporal lobe placement may result in better outcomes,and this finding is clinically instructive.
作者
丁昊
房慧
徐慧敏
郑柯蔚
DING Hao;FANG Hui;XU Huimin(Zibo Mental Health Center,Zibo 255100,China)
出处
《国际精神病学杂志》
2026年第1期16-20,31,共6页
Journal Of International Psychiatry
基金
淄博市医药卫生科研项目(编号:20230310035)。
关键词
无抽搐电休克
抑郁症
META分析
Modified electroconvulsive therapy
Depression
Meta-analysis
