摘要
目的系统评价中药复方联合帕罗西汀治疗广泛性焦虑症(GAD)的疗效和安全性。方法检索中国知网(CNKI)、万方、维普(VIP)和中国生物医学文献数据库(CBM)中,查找中药复方联合帕罗西汀治疗广泛性焦虑症的随机对照试验(RCTs),检索时限均从建库至2024年2月17日。对照组使用帕罗西汀治疗,试验组在对照组的基础上联合中药复方治疗。通过Cochrane风险偏倚评价工具和改良后Jadad量表评估纳入文献的方法学质量,运用Stata16.0进行统计学分析。结果共纳入23篇RCTs,包括试验组患者851例,对照组患者844例。Meta分析结果表明,试验组减少汉密尔顿焦虑量表(HAMA)评分[WMD=-2.83,95%CI(-3.72,-1.94),P<0.05],减少焦虑自评量表(SAS)评分[WMD=-4.95,95%CI(-7.08,-2.82),P<0.05],提高治疗有效率[OR=1.18,95%CI(1.01,1.37),P<0.05]均显著优于对照组。在降低不良反应发生率方面,试验组显著低于对照组[OR=0.46,95%CI(0.31,0.68),P<0.05]。结论中药复方联合帕罗西汀在GAD的治疗中发挥着比单纯使用帕罗西汀更好的疗效与安全性。由于纳入的文献的方法学质量评估均为低质量文献,后续还需更多的高质量多中心的RCTs来评估中药复方联合常规西药的疗效和安全性。
Objective To systematically evaluate the effectiveness and safety of traditional Chinese medicine(TCM)compounds combined with paroxetine in the treatment of generalized anxiety disorder(GAD).Methods CNKI,Wanfang,VIP and CBM were searched from the beginning of the database to February 17,2024 for Randomized controlled trials(RCTs)of TCM compounds combined with paroxetine in the treatment of GAD.The control group was treated with paroxetine,and the test group was treated with TCM compounds and paroxetine.The Cochrane risk bias assessment tool and improved Jadad scale were utilized for literature methodological quality evaluation.Stata 16.0 software was used for statistical analysis.Results A total of 23 RCTs were included,with 851 patients in the test group and 844 patients in the control group.Meta analysis showed that the test group reduced HAMA score[WMD=-2.83,95%CI(-3.72,-1.94),P<0.05],reduced SAS score[WMD=-4.95,95%CI(-7.08,-2.82),P<0.05],improved treatment response rate[OR=1.18,95%CI(1.01,1.37),and P<0.05]were significantly better than the control group.In terms of reducing the incidence of adverse reactions,the test group was significantly lower than the control group[OR=0.46,95%CI(0.31,0.68),P<0.05].Conclusion TCM compounds combined with paroxetine has better efficacy and safety in the treatment of GAD compared with paroxetine alone.Since the methodological quality assessment of the included literature is all low-quality literature,more high-quality multi-center RCTs are needed to evaluate the efficacy and safety of TCM compound combined with conventional western medicine.
作者
叶嘉俊
李文威
仇志坤
YE Jia-jun;LI Wen-wei;QIU Zhi-kun(Key specialty of clinical Pharmacy,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)
出处
《中国处方药》
2024年第10期28-33,共6页
Journal of China Prescription Drug
基金
中央财政医疗服务与保障能力提升补助资金资助项目(Z155080000004)。
关键词
中药复方
中医药
帕罗西汀
广泛性焦虑症
有效性
安全性
META分析
Chinese medicine compounds
Traditional Chinese medicine
Paroxetine
Generalized anxiety disorder
Effectiveness
Safety
Meta-analysis
