小剂量三环类抗抑郁药治疗肠易激综合征疗效及安全性的荟萃分析  

Efficacy and safety of low-dose tricyclic antidepressants in patients with irritable bowel syndrome: a meta-analysis

作　　者：王西艳[1] 冯玉光[1] 张红梅[1] 鞠丽英[1] 白红霞[1] 高桂鹏[1] 张金花[1] 

机构地区：[1]潍坊医学院,山东省潍坊市261042

出　　处：《世界华人消化杂志》2011年第33期3458-3463,共6页World Chinese Journal of Digestology

摘　　要：目的:系统评价三环类抗抑郁药治疗肠易激综合征的疗效和安全性.方法:计算机检索PubMed数据库、Cochrane图书馆临床对照试验数据库、中国生物医学文献数据库、中国期刊全文数据库,查找三环类抗抑郁药治疗肠易激综合征的双盲安慰剂随机对照试验,应用Cochrane协作网提供的Revman4.2软件进行分析评价.结果:共纳入8项试验,334例患者.治疗使用的药物包括阿米替林、米帕明、地昔帕明、多虑平、三甲丙咪嗪.高质量的随机对照试验表明,三环类抗抑郁药改善肠易激综合征总体症状缓解率(72.43%)明显高于安慰剂(40.76%)[RR=1.79,95%CI=(1.48,2.17),P<0.05],改善腹痛评分疗效优于安慰剂[SMD=-1.68,95%CI(-3.13,-0.23),P<0.05],不良反应的发生率与安慰剂组相比无明显统计学差异[RR=1.34,95%CI=(0.91,1.96),P>0.05].结论:小剂量三环类抗抑郁药对减轻肠易激综合征患者的各种症状、特别是缓解腹痛方面是有效和安全的.AIM： To systematically assess the efficacy and safety of low-dose tricyclic antidepressants （TCAs） for irritable bowel syndrome （IBS）. METHODS： PubMed, The Cochrane Central Register of Controlled Trials and Chinese Biomedical Literature Database, and CNKI were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. The Revman4.2 software provided by the Cochrane Collaboration was used for assessment. RESULTS： Eight placebo-controlled, doubleblind, randomized trials including 334 patients were involved in this analysis. TCAs used in these studies included amitriptyline, imipra-,mine, desipramine, doxepin and trimipramine. Compared to placebo （40.76%）, TCAs （72.43%） were associated with a higher rate of global symptom relief [40.76% vs 72.43%; RR = 1.79, 95%CI = （1.48, 2.17）, P 0.05]. There was a greater improvement in abdominal pain score [SMD = -1.68, 95%CI = （-3.13, -0.23）, P 0.05）] with TCAs than placebo. There was no significant difference in the incidence of serious adverse events between the TCA and placebo groups [RR = 1.34, 95%CI = （0.91, 1.96）, P 0.05]. CONCLUSION： Low-dose TCAs may be effec- tive and safe in relief of the symptoms of IBS patients, especially in the improvement of abdominal pain score.

关 键 词：三环类抗抑郁药 肠易激综合征 系统评价 荟萃分析 

分 类 号：R971.4[医药卫生—药品]