度洛西汀治疗抑郁症临床疗效及安全性国内研究的meta分析  

Efficacy and safety of duloxetine for depression in China： a meta-analysis

作　　者：朱建峰[1] 金卫东[2] 孙峰俐 Zhu Jianfeng1, Jin Weidong2, Sun Fengli2(1.The Second Clinical College of Zhejiang Chinese Medicine University, Hangzhou 310053, China ;2.Department of Psychiatry, Zhejiang Province Tongde Hospital, Hangzhou 310012, China)

机构地区：[1]浙江中医药大学第二临床学院,杭州310053 [2]浙江省立同德医院精神科,杭州310012

出　　处：《中华行为医学与脑科学杂志》2018年第9期858-864,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家中医药管理局中医心理学重点学科项目（国中医药人教发2012-32）;浙江省中西医结合中医临床心理学项目（2012-XK-A02）

摘　　要：目的系统评价国内抑郁症患者住院期间服用度洛西汀治疗的疗效与安全性，并与同期入组的服用SSRIs类药物治疗抑郁症的患者进行比较，探寻两者之间的差异性，以指导临床用药。方法计算机检索中国生物医学文献数据库、万方医学网数据库、中国知网、维普数据库和Pubmed数据库，纳入设计度洛西汀治疗成人抑郁症的随机、对照、双盲试验，按照Cochrane Handbook 5．0的质量评价标准评价纳入研究的质量后，采用RevMan5．3软件进行Meta分析。结果共纳入7项研究，度洛西汀与氟西汀比较2项，度洛西汀与帕罗西汀比较5项，合计1193例抑郁症患者。Meta分析结果显示：①治疗6-8周后度洛西汀组与氟西汀组／帕罗西汀组的有效率差异无统计学意义（RR=1．02，95％CI=0．78～1．32，Z=0．12，P=0．90），其最终治愈率差异亦无统计学意义（RR=0．95，95％CI=0．75～1．19，Z=0．47，P=0．64）。②不良反应：度洛西汀组与氟西汀组／帕罗西汀组常见的不良反应差异无统计学意义（RR=1．03，95％CI=0．86～1．23，Z=0．32，P=0．75）。结论度洛西汀在6～8周疗程结束时有效率及最终治愈率与氟西汀／帕罗西汀无差异；在常见不良反应中，不存在差异。Objective To systematically evaluate the efficacy and adverse effects of duloxetine in the treatment of domestic depression patients, and compare with those who were treated with SSRIs drugs in the same period to explore the difference between them to guide the clinical medication. Methods A search was conducted in CBMdisc, Wanfang database, CNKI, VIP, Pubmed. The double-blind randomized controlled trials on duloxetine for depression in China were collected. The quality of the included trials was assessed according to the Cochrane Handbook 5.0, and the systematic analysis was conducted by using RevMan 5.3 soft ware. Results Seven double-blind randomized controlled trials （ two of duloxetine versus fluoxetine, five of duloxetine versus paroxetine） involving 1 193 patients were included. The results of meta-analysis showed that ：（1）After 6-8 weeks of treatment, there were no significant differences in the effective rate （RR = 1.02, 95%CI= 0. 78-1.32,Z=0. 12,P= 0. 90） ,and the final cure rate （RR=0. 95,95%CI=0. 75-1.19,Z= 0. 47, P= 0.64） between the duloxetine and fluoxetine/paroxetine groups. （2）Adverse reactions：the incidence rate was not significantly different between duloxetine and fluoxetine/paroxetine groups （ RR = 1. 03,95% CI= 0.86-1.23, Z= 0. 32,P= 0.75 ）. Conclusion After 6-8 weeks of treatment, there are no significant differences in the effective rate and the final cure rate between duloxetine and fluoxetine/paroxetine. There is no significantly difference in common adverse reactions.

关 键 词：度洛西汀 抑郁症 META分析 随机对照双盲实验 疗效 安全性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]