达营方药联合抗精神病药治疗精神分裂症和周期性精神病的系统评价  

Clinical effectiveness of Daying formula combined with antipsychotics on schizophrenia and menstrual psychosis:A systematic review

作　　者：郑毓真 魏宇梅 李妍[1,2] 李华芳 ZHENG Yuzhen;WEI Yumei;LI Yan(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200032,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海市200032 [2]上海市精神心理疾病临床医学研究中心 [3]上海市重性精神病重点实验室

出　　处：《精神医学杂志》2023年第1期11-16,共6页Journal of Psychiatry

基　　金：上海市精神心理疾病临床医学研究中心课题(编号:19MC1911100);上海市科委生物医药领域科技支撑项目(编号:22S21902300);上海市精神卫生中心院级课题(编号:2021-HY-008)。

摘　　要：目的系统评价达营方药联合抗精神病药物治疗精神障碍(精神分裂症和周期性精神病)的有效性和安全性。方法计算机系统检索Pubmed、Embase、Cochrane Library、Web of Science,以及中国知网(CNKI)、万方数据(Wanfang Data)、维普资讯和中国生物医学文献服务系统(SinoMed)文献数据库。研究纳入标准为达营方药随机对照试验,采用Cochrane协作网推荐的偏倚风险评估工具进行文献质量评价。根据纳入文献的数量及质量,选择中药疗效Meta分析或定性综合叙述。结果达营方药的临床应用为精神分裂症和周期性精神病的辅助治疗。最终纳入了9项随机对照试验共627例患者,达营方药联合西药治疗组363例。因各项研究之间存在较大的方法学差异,仅进行描述性综合叙述。3项研究提示了达营方药联合抗精神病药改善精神分裂症总体症状和阴性症状的疗效优于西药对照组(P<0.05)。2项研究提示了达营方药辅助治疗周期性精神病有效率高于对照组(P<0.05)。3项研究报道了达营复方联合治疗精神分裂症的安全性,治疗组的口干,便秘和体质量增加发生率均低于对照组(P<0.05),而腹泻发生率9.8%则远高于对照组(P<0.05)。5项研究报道了达营复方联合治疗周期性精神病的安全性,总体药物不良反应发生率低于对照组(P<0.05);但均未报告其中具体不良反应发生率的P值。结论达营方药联合抗精神病药治疗精神分裂症和周期性精神病具有一定的疗效;除较高的腹泻发生率,联合治疗未显示其他药物不良反应的增加。Objective To explore the efficacy and safety of Daying formula as add-on therapy combined with antipsychotics for patients with schizophrenia or menstrual psychosis.Methods Data about randomized controlled trials(RCTs)of the Daying formula from Wanfang Data,CNKI,Pubmed,Embase,Cochrane Library,Web of science,VIP and SinoMed were collected,and risk of bias was assessed according to the Cochrane Handbook.Meta-analysis or a narrative synthesis was performed based on the heterogeneity and the number of studies included.Results The application of the Daying formula on mental disorders is the adjuvant treatment of schizophrenia or menstrual psychosis.A total of 9 clinical trials(627 participants)were included,containing 363 cases in the add-on therapy group with the formula and conventional treatment.Because of the insufficient number of RCTs and their heterogeneity in the treatment,a narrative synthesis was performed.3 studies showed that the formula when combined with the treatment of antipsychotics was more effective than the control group in improving the overall symptoms and negative symptoms of schizophrenia(P<0.05).2 studies showed a higher response rate of the formula in adjuvant treatment of menstrual psychosis(P<0.05).3 studies reported on the safety of the treatment for schizophrenia:lower rates of dry mouth,constipation,and weight gain compared to the control group(P<0.05)were observed,however,the incidence of diarrhea(9.8%)was significantly higher than that in control group(P<0.05).5 studies reported on the safety of the treatment for menstrual psychosis,with an overall lower incidence of adverse drug reactions compared to the control group(P<0.05).However,the specific incidence rates of adverse reactions were not reported with corresponding P-values.Conclusion Daying formula combined with antipsychotics have positive effects on schizophrenia or menstrual psychosis;and there is no indication of increase of other adverse reactions associated with the combination treatment except an increased occurrence of di

关 键 词：中药 达营方药 精神分裂症 周期性精神病 系统评价 

分 类 号：R749.05[医药卫生—神经病学与精神病学]