氯氮平片联合利培酮片治疗难治性精神分裂症安全性的系统评价  

Systematic review of the safety profile of clozapine tablets combined risperidone tablets on refractory schizophrenia

作　　者：李媛媛[1] 张云淑[1] 王红英[1] 栗克清[1] 

机构地区：[1]河北省第六人民医院心身疾病科,河北省保定071000

出　　处：《中国临床药理学杂志》2017年第18期1813-1816,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省青年基金资助项目(20120254)

摘　　要：目的系统评价氯氮平片联合利培酮片治疗难治性精神分裂症的安全性。方法电子检索Medline、Em Base、中国生物医学文献数据库等中英文数据库,截至2016-11-30。纳入关于氯氮平合并利培酮治疗难治性精神分裂症的随机对照试验(RCT)、半RCT(Quasi-RCT),试验组予以氯氮平联合利培酮治疗,对照组予氯氮平治疗。依据Cochrane 5.1.0版质量评价标准评价研究质量和提取数据进行Meta分析。结果共纳入9个研究,共计781例患者。Meta分析结果显示:氯氮平联合利培酮治疗难治性精神分裂症的安全性较高,在便秘、流涎、嗜睡、头晕、白细胞减少、心动过速、心电图异常等7个方面的药物不良反应发生率合用组均低于单用组(P<0.05),在肌张力增高、静坐不能、震颤等3个药物不良反应方面组间差异无统计学意义(P>0.05)。结论氯氮平联合利培酮治疗难治性精神分裂症不是简单的药物叠加,可减少单用时因剂量过高导致的药物不良反应,安全性较高,可作为难治性分裂症治疗的策略之一。Objective To evaluate the safety profile of clozapine tablets combined risperidone tablets for refractory schizophrenia. Methods We searched Medline,Em Base,CBM in both English and Chinese from the date of their establishment to November 30 th,2016,for randomized controlled trials（ RCTs）,quasi randomized controlled trials（ Quasi-RCTs）about clozapine combined risperidone for refractory schizophrenia. Treatment group received clozapine combined risperidone. Control group received clozapine alone. Quality assessment and data extraction were conducted with the Cochrane Collaboration＇ s Rev Man 5. 1. 0 software.Results A total of 9 trials involving 781 patients met the inclusion criteria. Results showed that the safety of clozapine combined risperidone most superior to clozapoine alone（ P〈0. 05）,except for acute dystonia,akathisia and tremor（ P〉0. 05）. Conclusion It was not just a simple addition for the clozapine combined risperidone. It may reduce the incidence of adverse reaction caused by high dose,and had a higher security. So it could be used as one of the treatment strategies for the refractory schizophrenia.

关 键 词：氯氮平 利培酮 难治性精神分裂症 安全性 Meta分析 

分 类 号：R971[医药卫生—药品]