阿戈美拉汀与SSRI、SNRI类药物治疗抑郁症疗效与安全性的Meta分析  

Efficacy and safety of agomelatine and SSRIs or SNRIs treating depression:a Meta-analysis

作　　者：邹卿[1] 袁也丰[1] 孙伟铭[2] 童恋茹 姜超[1] 董香丽 

机构地区：[1]南昌大学第一附属医院心身医学科,南昌330006 [2]南昌大学第一附属医院康复医学科,南昌330006

出　　处：《重庆医科大学学报》2017年第10期1288-1292,共5页Journal of Chongqing Medical University

摘　　要：目的:利用Meta分析的方法分别评估阿戈美拉汀与选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)、选择性5-羟色胺和去甲肾上腺素再摄取抑制剂(serotonin noradrenaline reuptake inhibitor,SNRI)类药物治疗抑郁症的疗效,为临床治疗提供参考。方法:计算机检索Cochrane library、Pubmed、Elsevier、中国知网、维普数据库、中国生物医学数据库、万方数据库,收集阿戈美拉汀与SSRI、SNRI类药物治疗抑郁症的随机对照试验(randomized controlled trial,RCT),对符合纳入标准的临床研究进行质量评价和资料提取后,采用Rev Man5.2统计软件进行Meta分析。结果:研究共纳入8项RCTs,总计2 632例患者;Meta分析结果显示,阿戈美拉汀组患者有效率(RR=1.07,95%CI=1.01~1.12,P=0.010)、治愈率(RR=1.10,95%CI=1.01~1.20,P=0.030)均明显高于SSRI、SNRI类药物组,抑郁量表终点评分与基线的差值值高于SSRI、SNRI类药物组(MD=0.46,95%CI=-0.13,1.05,P=0.130),2组差异无统计学意义。阿戈美拉汀在不良反应反应方面优于SSRI、SNRI类药物组(RR=0.50,95%CI=0.37~0.68,P=0.000),差异存在统计学意义。结论:阿戈美拉汀较其他SSRI、SNRI类药物治疗抑郁症的疗效更好、更安全。尚需高质量、大样本RCT研究进一步验证。Objective ：To explore the efficacy and safety of agomelatine in comparison with selective serotonin reuptake inhibitors （SS- RIs） and serotonin noradrenaline reuptake inhibitor（SNRls） used as anti-depressants in treatment of depressive disorder. Methods： Computer retrieval Cochrane library, Pubmed,Elsevier, CNKI, VIP, CBM,WanFang electronic database searches were performed to i- dentify reports of head-to-head randomized controlled trials that have compared agomelatine with SSRIs or SNRIs in terms of efficacy/ effectiveness in treating depressive disorder. The clinical trails meet the eligibility criteria for quality evaluation and information were extracted, and the RevMan 5.2 statistic software was used for Meta analysis. Results ： A total of 8 RCTs were enrolled including 2 632 patients. Meta-analysis results showed that agomelatine had higher response rates（RR=1.07,95%CI=1.01 to 1.12,P=0.010） compared with SSRIs and SNRIs. In the remission analysis, remission rates（RR=1. 10,95%CI=1.01 to 1.20, P=0.030） were significantly different. Depression scale at the end of the scale and the baseline values was higher than in agomelatine group than in SSRI or SNRI drug groups （MD=0.46,95%CI=-0.13 to 1.05 ,P=0.130） without significant differences between the two groups. Agomelatine group was su- perior to SSRIs and SNRIs groups in side effects（RR=0.50,95%CI=0.37 to 0.68,P=0.000）. Conclusion：Agomelatine has significantly higher efficacy and lower side effects compared with SSRIs and SNRIs when treating depression. However,this conclusion needs further validation by high quality and large sample RCTs.

关 键 词：阿戈美拉汀 抑郁症 META分析 随机对照试验 

分 类 号：R749.41[医药卫生—神经病学与精神病学]