催产素增效治疗精神分裂症有效性和安全性的Meta分析  

Effectiveness and safety of adjunctive oxytocin in the treatment of schizophrenia:a meta-analysis

作　　者：敖媛媛 杜健 高堂雨 刘薇[1] AO Yuan-yuan;DU Jian;GAO Tang-yu;LIU Wei(Psychiatry Deparment,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院精神科,150001 [2]南京脑科医院

出　　处：《临床精神医学杂志》2023年第1期24-28,共5页Journal of Clinical Psychiatry

基　　金：国家重点研发计划(2018YFC1314300)。

摘　　要：目的:探究催产素增效治疗精神分裂症的有效性和安全性。方法:检索PubMed、EMBASE、Cochrane Library、Wed of Science以及中国知网、万方数据、维普和中国生物医学文献数据库,收集相关随机对照试验(RCT)。结果:共纳入13项RCT,涉及受试者460例。Meta分析结果显示:催产素增效治疗对精神分裂症阴性症状的疗效优于对照组(SMD=-0.42,95%CI:-0.66~-0.17,P=0.0010),但对总精神病理症状(SMD=-0.16,95%CI:-0.44~0.12,P=0.27)、阳性症状(SMD=-0.18,95%CI:-0.48~0.11,P=0.23)、一般病理症状(SMD=-0.28,95%CI:-0.61~0.05,P=0.10)的改善不明显。在对精神症状的剂量-效应分析中发现,更高剂量的催产素(≥48 IU/d)不仅能够改善阴性症状(SMD=-0.40,95%CI:-0.66~-0.14,P=0.003),对一般病理症状(SMD=-0.44,95%CI:-0.82~-0.06,P=0.02)也有缓解作用。对两组各项不良反应进行分析,差异均无统计学意义(P>0.05)。结论:催产素的增效治疗能够改善精神分裂症患者的阴性症状,更高剂量的催产素(≥48 IU/d)对一般病理症状也有一定疗效,且安全性较高。Objective:To explore the effectiveness and safety of oxytocin synergistic therapy in the treatment of schizophrenia.Method:PubMed,EMBASE,Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP and China Biomedical Literature Database were searched and related randomized controlled trials(RCT)were collected.Results:A total of 13 RCTs were included,involving 460 subjects.Meta-analysis results showed that the oxytocin synergistic treatment had better effect on negative symptoms of schizophrenia than the control group(SMD=-0.42,95%CI:-0.66--0.17,P=0.0010),but it had no significant improvment on total psychopathological symptoms(SMD=-0.16,95%CI:-0.44-0.12,P=0.27),positive symptoms(SMD=-0.18,95%CI:-0.48-0.11,P=0.23),and general pathological symptoms(SMD=-0.28,95%CI:-0.61-0.05,P=0.10).The dose-effect analysis of psychiatric symptoms showed that higher doses of oxytocin(≥48 IU/d)not only improved negative symptoms(SMD=-0.40,95%CI:-0.66--0.14,P=0.003)but also relieved general pathological symptoms(SMD=-0.44,95%CI:-0.82--0.06,P=0.02).The adverse reactions of the two groups were analyzed,and the differences were not statistically significant(P>0.05).Conclusion:Oxytocin synergistic treatment can improve negative symptoms.Higher doses of oxytocin(≥48 IU/d)also has a certain effect on and higher security on general pathological symptoms.

关 键 词：催产素 精神分裂症 META分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]