[關鍵詞]
[摘要]
目的 系統(tǒng)評價艾司西酞普蘭與西酞普蘭治療抑郁癥的療效與安全性。方法 計算機檢索Pubmed、Medline、Embase(via OVID)、EBSCO、中國學術期刊全文數(shù)據(jù)庫(CNKI)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、維普中文期刊全文數(shù)據(jù)庫(VIP)、萬方數(shù)據(jù)庫及相關臨床試驗注冊網(wǎng)中有關艾司西酞普蘭與西酞普蘭治療抑郁癥的隨機對照試驗(RCTs),檢索時限至2022年1月;2名研究者對納入文獻進行嚴格質量評價和數(shù)據(jù)、信息提?。徊捎肦evMan 5.3軟件對各效應指標進行Meta分析。結果 納入8項RCTs,高質量文獻占87.5%;共1 169例患者,其中試驗組(艾司西酞普蘭組)585例、對照組(西酞普蘭組)584例。Meta分析結果顯示:治療6周末,兩組治愈率[OR=1.70,95% CI(1.02,2.83),P<0.05]、有效率[OR=1.36,95% CI(1.01,1.81),P<0.05]比較,差異有統(tǒng)計學意義;兩組發(fā)生惡心事件的差異有統(tǒng)計學意義[RR=0.69,95% CI(0.49,0.98),P<0.05],失眠、厭食(食欲不振)、頭暈、轉氨酶升高等發(fā)生率差異無統(tǒng)計學意義(P>0.05)。結論 相比于西酞普蘭,艾司西酞普蘭治療抑郁癥的長期療效更佳,但惡心風險發(fā)生率較高,建議臨床使用時視患者耐受情況個體化選擇。
[Key word]
[Abstract]
Objective To systematically evaluate the efficacy and safety of escitalopram and citalopram in the treatment of depression. Methods Randomized controlled trials (RCTs) of escitalopram and citalopram in the treatment of depression were searched from PubMed, Medline, CNCID and other Chinese and English databases until January 2022. Two researchers carried out strict quality evaluation and data and information extraction on the included literature. RevMan 5.3 software was used for Metaanalysis of each effect index. Results Eight RCTs were included, accounting for 87.5% of high-quality literatures. A total of 1 169 patients were enrolled, including 585 in the experimental group (escitalopram group) and 584 in the control group (citalopram group). Meta-analysis showed that after 6 weeks of treatment, there were statistically significant differences in cure rate [OR = 1.70, 95%CI(1.02, 2.83), P<0.05] and effective rate [OR = 1.36, 95%CI(1.01, 1.81), P<0.05] between the two groups. In terms of safety, there was statistically significant difference in the incidence of nausea between the two groups [RR = 0.69, 95%CI(0.49, 0.98), P<0.05], while there was no statistically significant difference in the incidence of insomnia, anorexia (loss of appetite), dizziness and elevated aminotransferase (P>0.05). Conclusion Compared with citalopram, escitalopram has a better long-term efficacy in the treatment of depression, but has a higher risk of nausea. It is recommended that the clinical use of escitalopram be individualized according to patient tolerance.
[中圖分類號]
R971
[基金項目]
國家自然科學基金資助項目(82004073);四川省科技廳科技計劃苗子工程重點項目(2022JDRC0146);四川省醫(yī)學會(恒瑞)科研基金專項科研課題(2021HR26)