米氮平辅助治疗精神分裂症阴性症状疗效与安全性的Meta分析  

A Meta analysis on efficiency and safety of mirtazapine in treatment of negative symptoms in schizophrenia

作　　者：郭菁[1,2] 李雷雷 黄婷[2] 曹笃[1,2] 谢鹏[1,2] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016 [2]重庆医科大学神经科学研究中心,重庆市神经生物学重点实验室,重庆400016 [3]中国疾控预防控制中心卫生应急中心监测预警与风险评估办公室,北京102206

出　　处：《第三军医大学学报》2013年第18期1984-1988,共5页Journal of Third Military Medical University

基　　金：国家重点基础研究发展计划(973计划;2009CB918300)~~

摘　　要：目的探索米氮平联合常规抗精神病药物治疗精神分裂症阴性症状的疗效与安全性。方法系统检索PubMed、Embase、Cochrane Controlled Trials Register(CCTR)、EBSCO、web of knowledge、psycINFO、中国知网(CNKI)、万方、中国生物医学数据库(CBM)以及维普(VIP)数据库,选择已发表的关于米氮平合并使用抗精神病药物治疗精神分裂症患者阴性症状的临床随机对照试验进行Meta分析,纳入文献截止时间为2012年10月11日。结果共纳入8项随机对照试验,米氮平联合抗精神病药物治疗精神分裂症阴性症状的有效率[OR(95%CI)=3.75(2.73,5.16)]和痊愈率[OR(95%CI)=2.21(1.23,3.99)]与单用抗精神病药物治疗有明显统计学差异,有效率与痊愈率均高于单用抗精神病药物治疗组(P<0.01)。米氮平联合抗精神病药物组的失眠与恶心的发生率明显低于单用抗精神病药物组(P<0.05),而嗜睡的发生率要高于单用抗精神药物组(P<0.05),其他不良反应的发生率差异均无统计学意义(P>0.05)。结论米氮平联合抗精神病药物能显著改善精神分裂症的阴性症状,同时并未增加抗精神病药物的常见副反应发生率。Objective To determine the efficacy as well as side effects of adding mirtazapine in the treatment of negative symptoms in schizophrenia.Methods Evidence-based relevant databases at home and abroad up to October 2012 were systematically searched for randomized placebo-controlled trails being published concerning mirtazapine combined with antipsychotics in the treatment of negative symptoms of schizophrenia.The literatures were collected for a Meta-analysis.Results Eight randomized controlled trails were included in our analysis.The effective rate [OR（95% CI） = 3.75（2.73,5.16） ]and the cure rate [OR（95% CI） = 2.21（1.23,3.99） ]respectively of adjunctive mirtazapine with conventional antipsychotic medications were statistically superior to those of antipsychotics monotherapy.Moreover,there were a lower incidence of insomnia and nausea and a higher incidence of drowsiness in adding mirtazapine group（P 0.05）.But there was no significant difference in the rest common side effects between combination therapy with mirtazapine and antipsychotics monotherapy（P 0.05）.Conclusion Mirtazapine in combination with antipsychotics is effective and mainly safe in treatment of negative symptoms in schizophrenia patients.

关 键 词：米氮平 精神分裂症 阴性症状 META分析 

分 类 号：R131.23[医药卫生—劳动卫生] R749.3[医药卫生—公共卫生与预防医学]