摘要
目的系统评价选择性钙离子通道阻滞剂(SCCBs)联合选择性5-羟色胺再摄取抑制剂(SSRIs)治疗肠易激综合征(IBS)的疗效和安全性。方法检索PubMed、Embase、Web of Science、Cochrane Library、CBM、CNKI、万方和维普等数据库,获取2020年1月30日之前发表的SCCBs联合SSRIs治疗IBS的随机对照试验(RCTs);通过文献筛选和质量评价后,提取相应结局指标,通过RevMan 5.3和Stata 14.2进行Meta分析。结果最终纳入13篇RCTs,共计1306例受试者。Meta分析结果显示:与单用SCCBs相比,SCCBs联合SSRIs提高了总有效率(RR=1.31,95%CI:1.20~1.43,P<0.00001),治疗后的焦虑评分(SMD=-0.72,95%CI:-1.30~-0.14,P=0.02)和抑郁评分(SMD=-0.97,95%CI:-1.18~-0.76,P<0.00001)也有明显下降,两组不良反应发生率差异无统计学意义(RR=0.72,95%CI:0.37~1.38,P=0.32)。结论SCCBs联用SSRIs类抗抑郁药较单用SCCBs可提高IBS患者治疗的总有效率,改善抑郁和焦虑症状,且未增加不良反应。
Objective To systematically evaluate the efficacy and safety of selective calcium channel blockers(SCCBs)plus selective serotonin reuptake inhibitors(SSRIs)in the treatment of irritable bowel syndrome(IBS).Methods All randomized controlled trials(RCTs)of SCCBs plus SSRIs for IBS,published before Jan.30th,2020,were collected by searching databases such as PubMed,Embase,Web of Science,Cochrane Library,CBM,CNKI,WanFang and VIP.The corresponding outcomes were extracted after literature screening and quality evaluation,and RevMan 5.3 and Stata 14.2 were used for Meta-analysis.Results Thirteen RCTs including 1306 patients were identified.The results of Meta-analysis showed that the total effective rate of the combined treatment group was significantly improved compared with SCCBs alone(RR=1.31,95%CI:1.20-1.43,P<0.00001).After treatment,anxiety scores(SMD=-0.72,95%CI:-1.30--0.14,P=0.02)and depression scores(SMD=-0.97,95%CI:-1.18--0.76,P<0.00001)were statistically lower than SCCBs alone,while there was no significant difference in the incidence of adverse reactions between two groups(RR=0.72,95%CI:0.37-1.38,P=0.32).Conclusion The efficacy of SCCBs plus SSRIs is superior to SCCBs alone in the treatment of IBS without increased adverse reactions.
作者
魏延
刘震雄
张哲
韩伟
吕丹丹
谢燕东
赵曙光
WEI Yan;LIU Zhenxiong;ZHANG Zhe;HAN Wei;LYU Dandan;XIE Yandong;ZHAO Shuguang(Department of Gastroenterology,the Second Affiliated Hospital of Air Force Medical University,Xi’an 710038,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第4期424-431,共8页
Chinese Journal of Gastroenterology and Hepatology
