摘要
目的:系统评价度洛西汀与安慰剂比较治疗老年抑郁症及广泛性焦虑障碍的疗效及安全性。方法:计算机检索PubMed、CochraneLibrary、EMbase、中国期刊全文数据库、中文科技期刊全文数据库、万方数字化期刊全文数据库,检索日期截至2016年11月。纳入度洛西汀与安慰剂比较治疗老年抑郁症及广泛性焦虑障碍的随机对照试验,按照Cochrane Handbook 5.1.0的质量评价标准评价纳入研究的质量后,采用Rev Man5.3软件进行meta分析。结果:共纳入6个研究,4篇研究针对老年抑郁症患者,2篇研究针对老年广泛性焦虑障碍患者。Meta分析结果显示:(1)治疗后度洛西汀组与安慰剂组的HAM-D治疗前后变化差值差异有统计学意义(SMD=-0.39,95%CI:-0.65^-0.12);HAM-A治疗前后变化差值差异亦有统计学意义(SMD=-0.54,95%CI:-0.76^-0.33);治疗后两组抑郁及焦虑痊愈率差异也有统计学意义。(2)治疗结束度洛西汀组与安慰剂组在总退出率、因不良反应退出率及严重不良反应发生率上差异无统计学意义;而在恶心、疲倦、便秘、口干、腹泻、嗜睡、出汗等不良反应发生率上两组差异有统计学意义,度洛西汀组发生率更高。(3)治疗后度洛西汀组与安慰剂组生活质量量表评分变化差值差异有统计学意义,度洛西汀能提高患者生活质量。结论:度洛西汀能提高老年抑郁症及广泛性焦虑障碍患者的临床治愈率,降低抑郁及焦虑量表评分,提高患者的生活质量,但增加恶心、疲倦、便秘、口干、腹泻、嗜睡、出汗等不良反应发生。
Objective： To systematically evaluate the efficacy and safety of duloxetine for elderly patients with depression or/and generalized anxiety disorder. Methods： A search was conducted in the Cochrane Library, Pubmed, EMbase, CNKI, VIP and Wanfang database. The randomized controlled trials（RCTs） on duloxetine versus placebo for elderly patients with depression or/and generalized anxiety disorder were included. The quality of the included trials was assessed according to the Cochrane Handbook 5.1.0, and the meta-analysis was conducted by using Rev Man 5.3 software. Results： Six studies（four for depression and two for generalized anxiety disorder） were included. The results of meta-analysis showed that： a） After treatment, there were significant differences in the scores of HAM-D（SMD =-0.39, 95%CI ：-0.65--0.12）, the scores of HAM-A（SMD =-0.54, 95%CI ：-0.76--0.33）, and the remission rate between the duloxetine and placebo groups. b） There were no significant differences in the overall dropout rates, discontinuation due to adverse events and severe adverse events, between the duloxetine and placebo groups. But the incidences rates of nausea, fatigue, constipation, dry mouth, diarrhea, somnolence and hyperhidrosis in the duloxetine group was higher than that of the placebo group. c） There were significant differences in the scores of quality of life scale between the duloxetine and placebo groups. Conclusion： According to the results, duloxetine may be effective for the treatment of elderly patients with depression or/and generalized anxiety disorder, but tends to have more adverse events.
出处
《临床药物治疗杂志》
2017年第11期54-59,共6页
Clinical Medication Journal
关键词
度洛西汀
老年
抑郁症
广泛性焦虑障碍
META分析
duloxetine
elderly patients
depression
qeneralized anxiety disorder
meta-analysis
