摘要
目的:系统评价艾司西酞普兰对比帕罗西汀治疗中国老年抑郁症患者的疗效与安全性,以为临床治疗提供循证参考。方法:计算机检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、中国生物医学文献数据库,收集艾司西酞普兰(试验组)对比帕罗西汀(对照组)治疗中国老年抑郁症患者的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取和质量评价后,采用Rev Man 4.2统计软件进行Meta分析。结果:共纳入14项RCT,合计1 148例患者。Meta分析结果显示,试验组患者痊愈率[OR=1.20,95%CI(0.93,1.53),P=0.16]、显效率[OR=1.23,95%CI(0.94,1.61),P=0.12]、头痛发生率[OR=0.81,95%CI(0.40,1.65),P>0.05]、心动过速发生率[OR=0.37,95%CI(0.09,1.52),P>0.05]、失眠发生率[OR=1.26,95%CI(0.33,4.82),P>0.05]、震颤发生率[OR=0.31,95%CI(0.04,2.24),P>0.05]与对照组比较,差异均无统计学意义;试验组患者口干发生率[OR=0.50,95%CI(0.31,0.80),P<0.05]、恶心发生率[OR=0.49,95%CI(0.36,0.66),P<0.05]、出汗发生率[OR=0.31,95%CI(0.15,0.62),P<0.05]、便秘发生率[OR=0.31,95%CI(0.15,0.64),P<0.05]、头晕发生率[OR=0.38,95%CI(0.20,0.72),P<0.05]、厌食发生率[OR=0.45,95%CI(0.21,0.99),P<0.05]均显著低于对照组,差异均有统计学意义。结论:艾司西酞普兰与帕罗西汀治疗中国老年抑郁症患者的疗效相当,但艾司西酞普兰的安全性优于帕罗西汀。但受纳入研究方法学质量和样本量限制,该结论有待更多设计严格、长期随访的大样本RCT加以验证。
OBJECTIVE： To systematically review the efficacy and safety of escitalopram versus paroxetine in treatment of se- nile patients with depression in China, and provide evidence-based reference for clinical treatment. METHODS： Retrieved from CJFD, VIP, Wanfang database, CBM database, randomized controlled trials （RCT） of escitalopram （test group） versus paroxetine （control group） in the treatment of senile patients with depression in China were collected. After quality evaluation and data ex- tract, Meta-analysis was performed by using Rev Man 4.2 statistics soft-ware. RESULTS ： A total of 14 RCT were included, involv- ing 1 148 patients. Results of Meta-analysis showed there was no significant difference in the cure rate[OR=l.20,95% CI（0.93, 1.53 ）, P= 0.16], significant effective rate[OR = 1.23,95 % CI （0.94, 1.61 ）, P = 0.12], the incidences of headache[OR = 0.81,95 % CI （0.40, 1.65）,P〉0.05],the incidences of tachycardia [OR=0.37,95%CI（0.09, 1.52）,P〉0.05],the incidences of insomnia [OR= 1.26,95%CI（0.33,4.82） ,P〉0.05] and the incidences of tremor [OR=0.31,95%CI（0.04,2.24）,P〉0.05] between test group and control group; the incidences of xerostomia[OR= 0,50,95 % CI （0.31,0.80）, P〈 0.05], the incidences of nausea[OR---- 0.49,95 % CI （0.36,0.66）, P〈0.05], the incidences of sweating [OR=0.31,95% CI （0.15, 0.62）, P〈0.05], the incidences of constipation[OR= 0.31,95% CI（0.15,0.64）, P〈0.05], the incidences of dizziness[OR=0.38,95%CI（0.20,0.72） ,P〈0.05] and the incidences of an- orexia[OR=0.45,95%CI（0.21,0.99） ,P〈0.05] in test group were significantly lower than control group, there were significant dif- ferences in 2 groups. CONCLUSIONS： The efficacy of escitalopram and paroxetine is similar in the treatment of senile patients with depression, however, the safety of escitalopram is better than paroxetine. Due to the limit of methodological quality and sam- ple size, it remains to be further verified with more rigorously designed and long
出处
《中国药房》
CAS
北大核心
2015年第27期3809-3812,共4页
China Pharmacy
