抗抑郁药物治疗产后抑郁的有效性和可接受性分析  

Analysis of the effectiveness and acceptability of antidepressants in the treatment of postpartum depression

作　　者：李文峰 许珂[2] 问馨 李猛 袁海 孔德荣 宓为峰[2] LI Wen-feng;XU Ke;WEN Xin;LI Meng;YUAN Hai;KONG De-rong;MI Wei-feng(IntensivePsychiatry,Zhengzhou Eighth People's Hospital,Zhengzhou 450015,Henan Province,China;National Institute for Drug Clinical Trial,Peking University Sixth Hospital,Peking University Institute of Mental Health,National Health Commission Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking UniversitySixth Hospital),Bejing 100083,China;Peking-Tsinghua CentreforLife Sciences,Peking University,Beijing 100084,China)

机构地区：[1]郑州市第八人民医院重症精神科,河南郑州450015 [2]北京大学第六医院、北京大学精神卫生研究所、国家卫生健康委员会精神卫生学重点实验室(北京大学)、国家精神心理疾病临床医学研究中心(北京大学第六医院)国家药物临床试验机构,北京100083 [3]北京大学北大清华生命科学联合中心,北京100084

出　　处：《中国临床药理学杂志》2025年第2期245-249,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的系统性评价抗抑郁药物治疗产后抑郁(PPD)的有效性和可接受性。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据库、维普中文数据库、中国生物医学文献服务系统(SinoMed)数据库,截止时间为2023年11月。筛选抗抑郁药物治疗PPD的随机对照试验(RCT),试验组给予抗抑郁药物,对照组给予安慰剂或另一种抗抑郁药物处置,用Stata 17.0软件对有效性和可接受性进行Meta分析。结果本研究共纳入27项RCT,共计2202例患者。Meta分析结果显示:与安慰剂有效性相比,排名前3的是米氮平[比值比(OR)=2.25,95%置信区间(95%CI)=1.20~3.30,P<0.05]、去甲替林(OR=1.50,95%CI=0.55~2.44,P>0.05)、文拉法辛(OR=1.35,95%CI=0.13~2.56,P>0.05);与安慰剂可接受性相比,排名前3的是中草药(OR=0.47,95%CI=-0.72~1.66,P>0.05)、去甲替林(OR=-0.08,95%CI=-1.16~1.33,P>0.05)、文拉法辛(OR=-0.12,95%CI=-1.47~1.24,P>0.05)。结论去甲替林、文拉法辛、曲唑酮和度洛西汀治疗PPD的有效性良好,且无明显药物不良反应。Objective To systematically evaluate the effectiveness and acceptability of antidepressant drugs in the treatment of postpartum depression(PPD).MethodsSThe PubMed,Cochrane Library,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Journals of Chinese Scienc were searched,and Chinese Biomedical Literature Service System(SinoMed)database until November 2023.Screen randomized controlled trials(RCTs)of antidepressant drugs for the treatment of PPD.The treatment group was given antidepressant drugs,and the control group was given placebo or another antidepressant drug.Meta-analysis of effectiveness and acceptability is performed using Stata 17.0 software.Results A total of 27 RCTs with a total of 2202 patients were included.The results of meta-analysis showed:The top three efficacy relative to placebo were mirtazapine[odds ratio(OR)=2.25,95%confidenceinterval(CI)=(1.20-3.30),P<0.05],nortriptyline[OR=1.50,95%CI=(0.55-2.44),P>0.05],venlafaxine[0R=1.35,95%CI=(0.13-2.56),P>0.05].Acceptability is compared with placebo in the top three Chinese herbal medicine[0R=0.47,95%CI=(-0.72-1.66),P>0.05],nortriptyline[OR=-0.08,95%CI=(-1.16-1.33),P>0.05],venlafaxine[0R=-0.12,95%CI=(-1.47-1.24),P>0.05].ConclusionNortriptyline,venlafaxine,trazodone,and duloxetine are effective in treating PPD without obvious adverse drug reactions.

关 键 词：抗抑郁药 产后抑郁 有效性 可接受性 网状meta分析 

分 类 号：R971.43[医药卫生—药品]