苯二氮类药物治疗抗精神病药物引起的迟发性运动障碍有效性及安全性系统评价  

Effectiveness and safety of benzodiazepines for antipsychotic-induced tardive dyskinesia: a meta analysis

作　　者：韩冬 周惠至 杨晨[1] 杨润许 王少华[1] 孙宁 张琨[1] 陈诗 孙黎[2] 康传媛 HAN Dong;ZHOU Huizhi;YANG Chen(Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院,云南昆明650032 [2]国家精神心理疾病临床医学研究中心(北京大学第六医院)儿童研究室 [3]同济大学附属东方医院(上海市东方医院)

出　　处：《精神医学杂志》2018年第2期89-93,共5页Journal of Psychiatry

基　　金：国家自然科学基金(编号:81460218;30900488);国家科技支撑计划项目(编号:2015BAI13B01)

摘　　要：目的系统评价苯二氮类药物(BZDs)对抗精神病药物引起的迟发性运动障碍(TD)的有效性和安全性。方法通过检索Pubmed、Cochrane Library、荷兰医学文摘(Excerpta Medica Database,EMBASE)、Ovid/MEDLINE、PsycI NFO、中国生物医学文献数据库、中国知识资源总库、中文科技期刊数据库、万方数据检索系统2017年7月30日之前收录的所有文章,搜集BZDs治疗抗精神病药物引起的TD的所有研究。结果首先纳入4篇研究,3篇随机对照试验,1篇自身交叉对照试验。试验组为单一的BZDs治疗(简称BZDs治疗组),对照组为安慰剂治疗或空白对照(简称对照组)。由于纳入研究的异质性较大,无法进行Meta分析,因此对异质性来源进行探讨。删除1篇异质性较大的自身交叉对照研究的数据后,对剩余3篇随机对照研究数据进行分析:经过4～6周干预后,治疗终点BZDs治疗组TD评定量表得分标准化均数差低于对照组(P<0.05)。采用二分变量统计,BZDs治疗组有效率高于对照组(P<0.05)。BZDs治疗的不良反应以困倦、眩晕等神经系统症状为主。结论目前该领域的研究仍然非常缺乏且质量不高,初步证据表明BZDs治疗抗精神病药物引起的TD有疗效,但需注意神经系统的副反应。Objective To undertake a meta analysis to evaluate the effectiveness and safety of benzodiazepines（ BZDs） for tardive dyskinesia（ TD） induced by antipsychotics. Methods Articles published by Pubmed,the Cochrane Library,Excerpta Medica Database（ EMBASE）,Ovid/MEDLINE,Psyc INFO,Sino Med,China National Knowledge Infrastructure（ CNKI）,VIP Periodical,and Wan Fang Data before July 30,2017 were collected to study benzodiazepines for antipsychotic-induced tardive dyskinesia. Results Three randomized controlled trials（ RCTs） and one cross-over trial were selected. Trial group was treated with benzodiazepine and control group was given placebo or nothing. The cross-over trial were excluded from the meta-analysis due to its heterogeneity,thus the rest three RCTs were finally included. The results showed that after 4-6 weeks intervention,the standardized mean difference（ SMD） of TD rating scaleswas lower than that of control group（ P 〈 0. 05）. Using the dichotomous variable statistics,the BZDs treatment group was more effective than the control group（ P 〈 0. 05）. The adverse reactions of BZDs treatment are mainly nervous system symptoms such as drowsiness and dizziness. Conclusions At present,research in this field is still very scarce and the quality is not high. Preliminary evidence indicates that BZDs are effective in treating TD caused by antipsychotic drugs,but attention should be paid to side effects of the nervous system.

关 键 词：迟发性运动障碍 苯二氮[艹卓]类 抗精神病药 Meta分析 

分 类 号：R749[医药卫生—神经病学与精神病学]