摘要
目的:利用网状Meta分析方法比较阿米替林、艾司西酞普兰、米氮平和文拉法辛4种不同机制的一线抗抑郁药治疗中国抑郁症患者临床疗效。方法:分别检索维普期刊资源整合服务平台、中国知网和万方数据知识服务平台(万方数据库)获取4种抗抑郁药治疗抑郁症的随机对照试验(RCT),检索时限均从建库至2015年7月。由两位研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,数据采用R软件和Gemtc软件进行分析。结果:共纳入129个研究,9371例患者,研究总臂数260。网状Meta结果显示,其他3种干预措施与阿米替林对比,艾司西酞普兰、米氮平和文拉法辛有效率的OR(95%Cl)值分别为1.6(95%Cl:1.3,2.0)、1.3(95%Cl:1.1,1.6)和1.4(95%Cl:1.2,1.6)。基于贝叶斯理论的网状Meta分析的等级排序结果显示,在推荐的排序中艾司西酞普兰、米氮平、文拉法辛和阿米替林的有效概率分别为95.92%、2.42%、1.66%、0.00%。结论:网状Meta分析结果表明,艾司西酞普兰治疗抑郁症的临床有效率最高,阿米替林临床有效率最低。受纳入研究数量和质量的影响,上述结论尚需开展更多高质量研究予以证实。
Objective： To systematically review the efficacy of 4 different therapeutic mechanisms antidepressants,namely,amitriptyline,escitalopram,mirtazapine and venlafaxine in treating depression disorder in China. Methods： The relative randomized controlled trials（ RCTs） about the 4 antidepressants in the treatment of depression disorder was searched in VIP,CNKI and Wan Fang Data from the date of their establishment to July 2015. Two reviewers independently screened literatures according to the inclusion and exclusion criteria,extracted data and conducted methodological quality evaluation. Network Meta-analysis was then performed using R and Gemtc software. Results： A total of 129 studies involving 9371 patients were included and the arm number is 260. The results of network Meta-analysis showed that,when the other 3 drugs are compared with amitriptyline,their OR（ 95% CI） of effective rate of escitalopram,mirtazapine and venlafaxine are 1. 6（ 95% Cl： 1. 3,2. 0） 、1. 3（ 95% Cl： 1. 1,1. 6） and 1. 4（ 95% Cl： 1. 2,1. 6）. The preferred ranking among all the rankings of network Meta-analysis based on Bayesian Theory also shows that,In the treatment of depression disorder,the probability of escitalopram, mirtazapine, venlafaxine and amitriptyline taking effect are 95. 92% 、2. 42% 、1. 66% and 0. 00%respectively. Conclusion： Through network Meta-analysis,escitalopram＇ s clinical effective rate is the highest and amitriptyline＇ s is the lowest. Due to the limited quantity and quality of included studies,more high quality studies are needed to verify the above conclusion.
出处
《中国药物评价》
2016年第2期106-110,共5页
Chinese Journal of Drug Evaluation
关键词
抑郁症
网状Meta分析
一线抗抑郁药
系统性评价
Depression disorder
Network Meta-analysis
First-line antidepressant drug
Systematic review
