目的 評(píng)價(jià)添加依匹哌唑治療重度抑郁癥的療效與安全性。方法 檢索PubMed、The Cochrane Library、Embase、中國(guó)期刊全文數(shù)據(jù)庫(kù)（CNKI）、萬(wàn)方數(shù)據(jù)庫(kù)、中文科技期刊全文數(shù)據(jù)庫(kù)（VIP）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM），獲取依匹哌唑添加治療重度抑郁癥的隨機(jī)對(duì)照試驗(yàn)（RCT），采用RevMan 5.20軟件進(jìn)行Meta分析。結(jié)果 共納入4篇RCT，5個(gè)研究，重度抑郁患者1 675例。Meta分析結(jié)果顯示：與安慰劑組相比，添加依匹哌唑組能更有效地降低治療末期蒙哥馬利抑郁評(píng)定量表總分[P=0.02，MD=-1.58，95%CI（-2.89，-0.27）]，顯著提高治療有效率[P<0.000 01，RR=1.59，95%CI（1.31，1.94）]、緩解率[P=0.000 4，RR=1.55，95%CI（1.22，1.96）]，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；在嚴(yán)重不良反應(yīng)、頭痛、失眠發(fā)生率方面，依匹哌唑組與安慰劑組相當(dāng)，差異無(wú)統(tǒng)計(jì)學(xué)意義；但在體質(zhì)量增加[P<0.000 01，RR=4.36，95%CI（2.45，7.77）]和靜坐不能[P<0.000 01，RR=3.39，95%CI（2.08，5.51）]發(fā)生率，依匹哌唑組顯著高于安慰劑組，差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。結(jié)論 添加依匹哌唑治療重度抑郁癥療效較好，但會(huì)增加一些不良反應(yīng)。

Objective Aim to evaluate the efficacy and safety of brexpiprazole as add on treatment for major depressive disorder (MDD). Methods The randomized controlled trials (RCTs) of brexpiprazole as add on treatment for MDD were searched from PubMed, The Cochrane Library, Embase, CNKI, Wan Fang, VIP, and CBM. Meta-analysis of the data was performed by using RveMan 5.2. Results Four RCTs were collected, including five studies and 1 675 patients with MDD. The results of Meta-analysis showed that compared with the placebo group, brexpiprazole group can effectively reduce the total score of MADRS at the end of treatment period[P=0.02, MD=-1.58, 95%CI(-2.89, -0.27)], the response rate[P < 0.000 01, RR=1.59, 95%CI(1.31, 1.94)] and remission rate[P=0.000 4, RR=1.55, 95%CI(1.22, 1.96)] are obviously increased, and all the differences are statistically significant (P < 0.05); In the incidence of serious adverse event, headache and insomnia, brexpiprazole group and the placebo group have no significant difference (P > 0.05); In the weight gain[P < 0.000 01, RR=4.36, 95%CI(2.45, 7.77), P < 0.000 01, RR=3.39, 95%CI(2.08, 5.51)] and the incidence of akathisia[P<0.000 01,RR=3.39,95%CI(2.08,5.51)], brexpiprazole group was significantly higher (P < 0.01) than that of the placebo group. Conclusion The therapeutic effect of treatment with the addition of of brexpiprazole on major depressive disorder is better, but it could increase the risk of adverse drug events.

重慶市社會(huì)事業(yè)與民生保障科技創(chuàng)新專項(xiàng)（cstc2015shmszx120073）