盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑效果比较的Meta分析  

Effectiveness and Safety of Trazodone versus Alprazolam for Adults' Generalized Anxiety Disorder: A Meta-Analysis

作　　者：张育勤[1] 范开华[1] 金伟华[1] 李丹[2] 米婷婷[1] 

机构地区：[1]成都军区总医院药剂科,成都610083 [2]成都医学院药学系,成都610083

出　　处：《中国循证医学杂志》2013年第1期100-105,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑的有效性及安全性。方法计算机检索PubMed(1980～2012.5)、CBM(1990～2012.5)、VIP(1989～2012.5)、CNKI(1990～2012.5)和Wanfang Data(1990～2012.5),收集盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑的随机对照试验,由两名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用RevMan 5.0软件进行Meta分析。结果纳入5个RCT,共403例广泛性焦虑症患者。Meta分析结果显示:①治疗4周后,盐酸曲唑酮组与阿普唑仑组的HAMA评分和治愈率的差异无统计学意义[RR=1.04,95%CI(0.95,1.13),P=0.38;RR=1.05,95%CI(0.75,1.48),P=0.76]。②盐酸曲唑酮组的嗜睡发生率低于阿普唑仑组[RR=0.42,95%C(I0.25,0.72),P=0.001],但两组在头晕、乏力、食欲减退发生率方面,差异无统计学意义[RR=0.52,95%C(I 0.27,1.01),P=0.05;RR=0.10,95%C(I 0.01,1.41),P=0.09;RR=2.82,95%C(I 0.28,28.23),P=0.38]。结论盐酸曲唑酮和阿普唑仑治疗广泛性焦虑的疗效无差异,但盐酸曲唑酮不良反应较少,而阿普唑仑更易引起嗜睡。由于纳入研究数量有限且方法学质量不高,本研究结果尚需更多高质量随机对照试验进一步证实。Objective To assess the effectiveness and safety of trazodone versus alprazolam on adults＇ generalized anxiety disorder （GAD）. Methods Such databases as PubMed （1980 to May 2012）, CBM （1990 to May 2012）, VIP （1989 to May 2012）, CNKI （1990 to May 2012） and WanFang Data （1990 to May 2012） were searched to collect the randomized controlled trials （RCTs） about trazodone vs. alprazolam for adults＇ GAD. According to the inclusion and exclusion crite- ria, two reivewers screened literature, extracted data and assessed the quality of the included studies, then meta-analysis was conducted using RevMan 5.0 software. Results A total of 5 RCTs involving 403 patients were included. The results of meta-analysis showed that： a） After four-week treatment, there were no significant differences between the two groups in the HAMA scores （RR=1.04, 95%CI 0.95 to 1.13, P=0.38） and cure rate （RR=1.05, 95%CI 0.75 to 1.48, P=0.76）; and b） The somnolence rate of the trazodone group was lower than that of the alprazolam group （RR=0.42, 95%CI 0.25 to 0.72, P=0.001）. But there were no significant differences between the two groups in dizziness （RR=0.52, 95%CI 0.27 to 1.01, P=0.05）, fatigue （RR=0.10, 95%CI 0.01 to 1.41, P=0.09）, and poor appetite （RR=2.82, 95%CI 0.28 to 28.23, P=0.38）. Conclusion There is no significant difference between razodone and alprazolam in the effectiveness when treating GAD, but razodone has lower side effects while alprazolam tends easily to cause somnolence. For the quantity limitation and low methodological quality of the included studies, this conclusion still needs to be further proved by more high quality RCTs.

关 键 词：曲唑酮 阿普唑仑 广泛性焦虑 META分析 系统评价 随机对照试验 

分 类 号：R749.72[医药卫生—神经病学与精神病学]