Adjunctive Peony-Glycyrrhiza decoction for antipsychotic-induced hyperprolactinaemia:a meta-analysis of randomised controlled trials  

作　　者：Wei Zheng Dong-Bin Cai Hai-Yan Li Yu-Jie Wu Chee H Ng Gabor S Ungvari Shan-Shan Xie Zhan-Ming Shi Xiao-Min Zhu Yu-Ping Ning Yu-Tao Xiang 

机构地区：[1]Department of Psychiatry,The Affliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital),Guangzhou,China [2]Department of Neurology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,China [3]Department of Psychiatry,University of Melbourne,Melbourne,Australia [4]The University of Notre Dame Australia,Fremantle,Australia [5]Division of Psychiatry,Medical School,University of Western Australia,Perth,Australia [6]Department of Psychiatry,Mental Health Center of Hebei Province,Baoding,China [7]Department of Psychiatry,Chongqing Jiangbei Mental Health Hospital,Chongqing,China [8]Department of Psychiatry,Suzhou Psychiatric Hospital,The Affliated Guangji Hospital of Soochow University,Suzhou,China [9]Unit of Psychiatry,Faculty of Health Sciences,University of Macao,Macao,China

出　　处：《General Psychiatry》2018年第4期3-9,共7页综合精神医学（英文）

基　　金：supported by the University of Macao(SRG2014-00019-FHS;MYRG2015-00230 FHS;MYRG2016-00005-FHS);the Affiliated Brain Hospital of Guangzhou Medical University(2016YFC0906302;81671334;2014Y2-00105;2015BAI13B02)

摘　　要：Background Hyperprolactinaemia is a common adverse effect of antipsychotics （APs）. The results of Peony-Glycyrrhiza decoction （PGD） as a potentially useful adjunctivetreatment for hyperprolactinaemia are inconsistent.Aim This meta-analysis of randomised controlled trials （RCTs） examined the effcacy and safety of adjunctive PGDtherapy for AP-induced hyperprolactinaemia.Methods English （PubMed, Embase, Cochrane Library, PsycINFO） and Chinese （Chinese National Knowledge Infrastructure, Wanfang Data） databases were systematicallysearched up to 10 June 2018. The inclusion criteria were based on PICOS-Participants： adult patients with schizophrenia; Intervention： PGD plus APs; Comparison： APs plus placebo or AP monotherapy; Outcomes： effcacy and safety; Study design： RCTs. The weighted mean difference （WMD） and risk ratio （RR） along with their 95% CIs were calculated using Review Manager （RevMan） V.5.3 software.Results Five RCTs （n=450） were included and analysed. Two RCTs （n=140） were double-blind and four RCTs （n=409） reported ‘random’ assignment with specifc description. The PGD group showed a signifcantly lower serum prolactin level at endpoint than the control group （n=380, WMD： ？32.69 ng/mL （95% CI -41.66 to 23.72）, p〈0.00001, I2=97%）. Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale （n=403, WMD： -0.62 （95% CI -2.38 to 1.15）, p=0.49, I^2=0%）. There were similar rates of all-cause discontinuation （n=330, RR 0.93 （95% CI 0.63 to 1.37）, p=0.71, I^2=0%） and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low’ （14.3%）, ‘low’ （42.8%）, ‘moderaBackground Hyperprolactinaemia is a common adverse effect of antipsychotics(APs). The results of PeonyGlycyrrhiza decoction(PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent.Aim This meta-analysis of randomised controlled trials(RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia.Methods English(PubMed, Embase, Cochrane Library,PsycINFO) and Chinese(Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PIC0 S一/^rticipants: adult patients with schizophrenia; Aitervention: PGD plus APs; Cbmparison: APs plus placebo or AP monotherapy;(Xjtcomes: efficacy and safety; Study design: RCTs. The weighted mean difference(WMD) and risk ratio(RR) along with their 95% CIs were calculated using Review Manager(RevMan) V.5.3 software.Results Five RCTs(n=450) were included and analysed.Two RCTs(n=140) were double-blind and four RCTs(n=409) reported ‘random' assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group(n=380, WMD:-32.69 ng/mL(95% Cl-41.66 to 23.72),/X0.00001, ^=97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale(n=403,WMD:-0.62(95% Cl-2.38 to 1.15), p=0.49, ^=0%). There were similar rates of all-cause discontinuation(n=330, RR0.93(95% Ci 0.63 to 1.37),/t=0.71, ^=0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low'(14.3%),‘low'(42.8%),‘moderate'(14.3%),to ‘high,(28.6%>.Conclusions Current evidence supports the adjunctive use of PGD to suppress elevated prolactin and impro

关 键 词：Adjunctive Peony-Glycyrrhiza decoction antipsychotic-induced hyperprolactinaemia a meta-analysis of randomised controlled trials 

分 类 号：R74[医药卫生—神经病学与精神病学]