目的 比較分析阿立哌唑與喹硫平治療老年精神分裂癥療效、不良反應(yīng)及藥物經(jīng)濟(jì)性。方法 檢索中國期刊全文數(shù)據(jù)庫（CNKI）、維普中文科技期刊全文數(shù)據(jù)庫（VIP）、萬方醫(yī)學(xué)網(wǎng)、PubMed、EBSCO、OVID等數(shù)據(jù)庫中阿立哌唑與喹硫平藥治療老年精神分裂癥的臨床隨機(jī)對照試驗(yàn)，檢索時限為建庫至2017年9月。采用循證醫(yī)學(xué)方法對2種藥品進(jìn)行療效及不良反應(yīng)分析，并應(yīng)用藥物經(jīng)濟(jì)學(xué)分析法評價其經(jīng)濟(jì)性。結(jié)果 納入10篇RCT，Meta-分析結(jié)果顯示：阿立哌唑與喹硫平治愈率差異無統(tǒng)計(jì)學(xué)意義（P>0.05），采用成本-效果分析法進(jìn)行藥物經(jīng)濟(jì)學(xué)分析；藥物不良反應(yīng)發(fā)生率方面，便秘[RR=0.39，95%CI（0.16~0.95）]、嗜睡[RR=0.32，95%CI（0.16~0.62）]及頭暈[RR=0.47，95%CI（0.27~0.81）]差異有統(tǒng)計(jì)學(xué)意義（P<0.05），其他不良反應(yīng)差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。成本-效果比分別為57.97%、31.32%。結(jié)論 阿立哌唑與喹硫平治療老年精神分裂癥在療效相當(dāng)?shù)那闆r下，喹硫平的用藥花費(fèi)相對較低，但發(fā)生便秘、嗜睡及頭暈風(fēng)險相對較高，臨床醫(yī)師在用藥選擇時，可根據(jù)患者實(shí)際情況個體化用藥。

Objective To comparatively analyze the efficacy, adverse reactions, and drug economy of aripiprazole and quetiapine in the treatment of senile schizophrenia.Methods Databases including CNKI, VIP, Wanfang, PubMed, EBSCO, and OVID Database were searched to collect randomized controlled trials (RCTs) about the aripiprazole and quetipiapine in the treatment of the senile schizophrenia from database establishment to September 2017. The efficacy and adverse reactions of two drugs were analyzed by evidence-based medicine, and pharmacoeconomic analysis was used to evaluate their economic effectiveness.Results Ten RCTs were collected. Meta-analysis results showed that at the end of the treatment period, the cure rate of aripiprazole and quetipiapine was no significant difference (P>0.05). Constipation[RR=0.39, 95%CI(0.16-0.95)], drowsiness[RR=0.32, 95%CI(0.16-0.62)] and dizziness[RR=0.47, 95%CI(0.27-0.81)] of adverse drug reactions were statistically significant (P<0.05), but there was no significant difference in other adverse reactions (P>0.05). The cost-effectiveness ratios were 57.97% and 31.32%.Conclusion Aripiprazole and quetiapine in the treatment of senile schizophrenia efficacy equivalent, quetiapine medication cost is relatively low, but the occurrence of constipation, drowsiness and dizziness, the risk is relatively high, clinicians in the drug selection, according to the actual situation of the patient individual choice.

西南醫(yī)科大學(xué)科技計(jì)劃基金資助項(xiàng)目（2017-ZRQN-133）