奥氮平和氟哌啶醇治疗谵妄的Meta分析  

Olanzapine Versus Haloperidol in the Treatment of Delirium:a Meta-analysis

作　　者：肖骋 肖劲松[1] 李华钢[1] 施余露[1] 

机构地区：[1]武汉大学中南医院神经内科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2015年第5期839-844,共6页Medical Journal of Wuhan University

摘　　要：目的:评价新型抗精神病药奥氮平和氟哌啶醇治疗谵妄的对比研究。方法:计算机检索Cochrane图书馆、Cochrane临床对照试验资料资料库、Pubmed、中国知网全文数据库、万方数据库2000年1月-2014年10月有关奥氮平和氟哌啶醇治疗谵妄的随机对照试验,并进行Meta分析。结果:共纳入4篇关于两种药物治疗谵妄的随机对照试验和1篇前瞻性非随机对照研究。Meta分析显示奥氮平对谵妄患者简易精神状态评价量表(MMSE)评分的改善优于氟哌啶醇,而对谵妄评定量表(DRS)评分和临床整体印象量表严重程度评分(CGI-SI)的改善与氟哌啶醇组无统计学差异。在副反应研究中,奥氮平的其他神经系统副反应少于氟哌啶醇,而消化系统和锥体外系副反应明显少于氟哌啶醇。结论:奥氮平治疗谵妄的疗效基本与氟哌啶醇相似,但安全性优于氟哌啶醇。由于本Meta分析存在一定方法学的局限性,我们需要更多的含有良好设计方法、样本量足够的多中心、大规模的临床试验来验证本研究结果的可靠性。Objective： To evaluate the clinical efficacy and safety of olanzapine and haloperidol in treatment of patients with delirium. Methods. We searched in the Cochrane library, Cochrane controlled trials register, Pubmed, WanFang database and CNKI to identify studies on prospective trials about olanzapine and haloperidol in treatment of patients with delirium from January 2000 to October 2014. A Meta-analysis was performed. Results. Four RCTs and one prospective observational study were included. There was no significant difference in improvement of DRS and CGI-SI scores of delirious patients between olanzapine and haloperidol group; Significant differences were found in the improvement of MMSE scores, incidence rate of adverse effects in digestive,other neurological system and extrapyramidal system between two groups （P〈0. 05）. Conclusion. Olanzapine and haloperidol were equally efficacious in the treatment of delirium. Olanzapine were safer than haloperidol. However, double-blind, randomized and multi-center studies are needed.

关 键 词：奥氮平 氟哌啶醇 谵妄 META分析 

分 类 号：R741.05[医药卫生—神经病学与精神病学]