文拉法辛治疗老年抑郁症的疗效和安全性随机对照研究的Meta分析  

Efficacy and safety of venlafaxine for late-life depression: a Meta-analysis of randomized controlled trials

作　　者：应印兵 刘毅 潘伟刚[1] 毛佩贤[1] 任艳萍[1] 鲍枫[1] 马辛[1] YING Yinbing, LIU Yi, PAN Weigang, MAO Peixian ,REN Yanping, BAO Feng, MA Xin(Beijing Anding Hospital Affiliated to Capital Medical University, Beijing 100088, China)

机构地区：[1]首都医科大学附属北京安定医院,北京100088

出　　处：《中国医药科学》2018年第15期34-39,共6页China Medicine And Pharmacy

摘　　要：目的系统评价文拉法辛治疗老年抑郁症的疗效和安全性。方法计算机检索中国生物医学文献数据库、万方数据库、中国学术期刊全文数据库和维普中文科技期刊数据库,全面检索文拉法辛治疗老年抑郁症相关文献,进行严格的质量评价后,使用Revman 5.3软件进行Meta分析。结果共纳入17项随机对照研究,1053例患者。Meta分析结果显示,文拉法辛组治疗2周汉密尔顿抑郁量表(HAMD)减分值(SMD=0.15,95%CI:-0.12~0.42,P=0.29)、终点有效率(RR=0.98,95%CI:0.91~1.06,P=0.61)及终点痊愈率(RR=0.97,95%CI:0.84~1.13,P=0.71)与对照组药物相比均未见统计学意义;亚组分析结果表明,文拉法辛高低剂量组分别同对照组药物相比,在治疗2周HAMD减分值及治疗终点有效率、痊愈率的比较中亦未见统计学意义。与对照组药物相比,文拉法辛组体重增加及口干的发生率更低,但更容易导致血压升高及心悸。结论文拉法辛能有效治疗老年抑郁症,但需留意其对血压的影响。Objective To systematically evaluate the efficacy and safety of venlafaxine in treatment of latelife depression. Methods The data of China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, China Science and Technology Journal Database were comprehensive retrieved by computer to search the articles about the venlafaxine in treatment of late-life depression. After a strict quality evaluation, Meta-analysis were performed in Revman 5.3. Results A total of 17 RCTs involving 1053 patients were finally included in the Meta-analysis. Meta-analysis results confirmed that, there was no significant difference between the two groups in either change from baseline scores of Hamilton Depression Scale（SMD=0.15, 95%CI：-0.12~0.42, P=0.29） after 2 weeks of treatment, efficiency rate（RR=0.98, 95%CI： 0.91~1.06, P=0.61） and cure rate（RR=0.97, 95%CI： 0.84~1.13, P=0.71） at the endpoint of treatment. Subgroup-analysis showed that, both the change from baseline scores of Hamilton Depression Scale after 2 weeks of treatment, the efficiency and cure rate at the endpoint of treatment had no significant differences between high dose or low dose of venlafaxine and other antidepressants. The weight gain and dry mouth rate of the venlafaxine group were lower than those of other antidepressants group, but venlafaxine more easily led to elevation of blood pressure and palpitation. Conclusion Venlafaxine is efficacious in late-life depression, but should pay attention to its effect on blood pressure.

关 键 词：文拉法辛 老年 抑郁症 META分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]