普拉克索治疗帕金森病抑郁的Meta分析
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摘要
目的系统评价普拉克索治疗帕金森病抑郁的临床疗效及不良反应。方法检索美国国立医学图书馆(PubMed)、荷兰医学文摘(EMbase)、Cochrane图书馆、中国知网(CNKI)、维普数据库(VIP)、万方数据库中关于普拉克索治疗帕金森病抑郁的随机对照研究(RCT)。参照纳入标准、排除标准进行筛选文献、提取文献资料及评估方法学质量,采用Review Manager 5.3软件进行Meta分析。结果最终纳入21项随机对照研究,共1 733例帕金森病抑郁患者。Meta分析显示:经过2～3个月的治疗,普拉克索治疗帕金森病抑郁的总有效率较对照组高(RR=1.28,95%CI:1.19～1.37,P<0.01);普拉克索可降低帕金森病抑郁患者的汉密尔顿抑郁量表(HAMD)评分(SMD=-1.01,95%CI:-1.31～0.71,P<0.01);普拉克索治疗帕金森病抑郁的不良反应发生率较安慰剂更低(RR=0.61,95%CI:0.39～0.97,P<0.05)。结论普拉克索可有效治疗帕金森病抑郁,降低其HAMD评分,且安全性良好。
Objective To systematically assess the efficacy and safety of pramipexole for treatment of depressive symptoms in Parkinson's disease(PD). Methods Clinical trials of pramipexole for treating depressive symptoms in PD patients were searched from PubMed, Embase, the Cochrane Library, China National Knowledge Infra-structure(CNKI),VIP Database for Chinese Technical Periodical(VIP) and Wanfang Data. Two investigators screened articles independently according to the inclusion and exclusion criteria, and performed data extraction and quality assessment.Meta analysis was conducted by using Review Manager 5.3 software. Results Twenty-one trials with 1733 cases were included for analysis.Meta analysis showed that compared with control group, pramipexole improved the overall response rate of clinical treatment(RR=1.28, 95%CI:1.19～1.37, P<0.01), decreased the HAMD score(SMD=-1.01, 95%CI:-1.31～-0.71, P<0.01) and reduced the incidence of adverse effects(RR=0.61, 95%CI:0.39～0.97, P<0.05). Conclusion Pramipexole has certain clinical benefit for treatment of depressive symptoms in patients with Parkinson's disease.
Objective To systematically assess the efficacy and safety of pramipexole for treatment of depressive symptoms in Parkinson's disease(PD). Methods Clinical trials of pramipexole for treating depressive symptoms in PD patients were searched from PubMed, Embase, the Cochrane Library, China National Knowledge Infra-structure(CNKI),VIP Database for Chinese Technical Periodical(VIP) and Wanfang Data. Two investigators screened articles independently according to the inclusion and exclusion criteria, and performed data extraction and quality assessment.Meta analysis was conducted by using Review Manager 5.3 software. Results Twenty-one trials with 1733 cases were included for analysis.Meta analysis showed that compared with control group, pramipexole improved the overall response rate of clinical treatment(RR=1.28, 95%CI:1.19～1.37, P<0.01), decreased the HAMD score(SMD=-1.01, 95%CI:-1.31～-0.71, P<0.01) and reduced the incidence of adverse effects(RR=0.61, 95%CI:0.39～0.97, P<0.05). Conclusion Pramipexole has certain clinical benefit for treatment of depressive symptoms in patients with Parkinson's disease.
引文
[1]中华医学会神经病学分会神经心理学与行为神经病学组.帕金森病抑郁、焦虑及精神病性障碍的诊断标准及治疗指南[J].中华神经科杂志,2013,46(1):56-60.
[2]Mhm T,Mhct VB,Bloem BR,et al.What a neurologist should know about depression in Parkinson's disease[J].Pract Neurol,2017,17(5):359-368.
[3]Frisina PG,Borod JC,Foldi NS,et al.Depression in Parkinson's disease:Health risks,etiology,and treatment options[J].Neuropsychiatric Disease&Treatment,2008,4(1):81-91.
[4]尚延昌,王淑辉,王振福,等.普拉克索治疗帕金森病合并抑郁的系统评价[J].现代生物医学进展,2010,10(2):280-283.
[5]Liu J,Dong J,Wang L,et al.Comparative efficacy and acceptability of antidepressants in Parkinson's disease:a network meta-analysis[J].Plos One,2013,8(10):e76651.
[6]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病治疗指南(第三版)[J].药学与临床研究,2014,4:428-433.
[7]李绒.普拉克索治疗老年帕金森病伴发抑郁的疗效观察[J].医学信息,2014,39:383-383.
[8]张运仓.普拉克索治疗帕金森病伴发抑郁障碍的对照研究[J].中国社区医师(医学专业),2012,14(30):185-185.
[9]林向,唐毅,叶云.普拉克索治疗帕金森病伴抑郁的疗效及安全性评价[J].中国实用神经疾病杂志,2014,17(12):98-99.
[10]戴美芬,余丹丽,赵丹,等.普拉克索治疗帕金森病伴抑郁的临床疗效观察[J].中国临床神经科学,2010,18(2):188-194.
[11]朱华伟,齐进兴,邓建中.普拉克索治疗帕金森病伴抑郁的临床效果[J].中国实用神经疾病杂志,2016,19(22):115-116.
[12]李杰.普拉克索治疗帕金森病伴抑郁患者的临床观察[J].河南医学研究,2014,23(3):87-88.
[13]高丽丽,孙德华,陈卫.普拉克索治疗帕金森病合并抑郁疗效观察[J].中国基层医药,2015,22(17):2619-2621.
[14]钱燕群,毛旭强,张剑平,等.普拉克索治疗帕金森病合并抑郁症的随机对照研究[J].现代生物医学进展,2011,s2:5069-5070.
[15]朱宝霞.盐酸普拉克索治疗帕金森病伴发抑郁45例分析[J].中国医药指南,2013,11(23):610-611.
[16]陈菲,黄财城,陈媚丽,等.普拉克索治疗帕金森病伴抑郁的临床效果分析[J].中国卫生标准管理,2016,7(14):83-84.
[17]李琳钰,季兴,张德敏,等.盐酸普拉克索联合美多巴对帕金森病合并抑郁患者的治疗效果分析[J].国际医药卫生导报,2016,22(15):2326-2328.
[18]李华丽,李冬冬,姚艳丽.普拉克索合美多巴治疗帕金森病合并抑郁30例临床观察[J].中国民族民间医药,2014,15:42-42.
[19]苏颖,刘郁东,孙洲,等.普拉克索与氟西汀治疗帕金森病合并抑郁症的随机平行对照研究[J].中华老年医学杂志,2010,29(1):1-4.
[20]方玲,汤义平.普拉克索治疗帕金森病伴发抑郁障碍的对照研究[J].浙江临床医学,2011,13(7):787-789.
[21]邓琦,白鹤,胡霞,等.普拉克索治疗帕金森病合并抑郁的疗效观察[J].现代养生,2014,10:159-160.
[22]马松华.普拉克索治疗帕金森病合并抑郁的疗效观察[J].现代中西医结合杂志,2011,20(3):319-320.
[23]邬至平,黄跃金,曾婷婷,等.普拉克索治疗帕金森病抑郁的临床疗效分析[J].中国高等医学教育,2016,3:134-135.
[24]祝美蓉,徐翠萍.普拉克索对帕金森病伴抑郁患者的临床疗效观察[J].大家健康(学术版),2014,15:85-86.
[25]张深山,叶凯文,高镇松.普拉克索治疗帕金森病伴发抑郁障碍临床疗效与安全性[J].广东医学,2010,31(7):908-910.
[26]Bxarone Paolo,Poewe Werner,Albrecht Stefan,et al.Pramipexole for the treatment of depressive symptoms in patients with Parkinson's disease:a randomised,double-blind,placebocontrolled trial[J].Lancet Neurol,2010,9(6):573-580.
[27]Barone Paolo,Scarzella Leonardo,Marconi Roberto,et al.Pramipexole versus sertraline in the treatment of depression in Parkinson's disease:a national multicenter parallel-group randomized study[J].J Neurol,2006,253(5):601-607.
[28]Kalia Lorraine V,Kalia Suneil K.Disease‐modifying strategies for Parkinson's disease[J].Movement Disorders,2015,30(11):1442-1450.
[29]Shulman LM,Taback RL,Rabinstein AA,et al.Non-recognition of depression and other non-motor symptoms in Parkinson's disease[J].Parkinsonism Relat Disord,2002,8:193-197.
[30]Seppi Klaus,Weintraub Daniel,Coelho Miguel,et al.The Movement Disorder Society Evidence-Based Medicine Review Update:Treatments for the non-motor symptoms of Parkinson's disease[J].Mov Disord,2011,26(Suppl 3):S42-80.
[2]Mhm T,Mhct VB,Bloem BR,et al.What a neurologist should know about depression in Parkinson's disease[J].Pract Neurol,2017,17(5):359-368.
[3]Frisina PG,Borod JC,Foldi NS,et al.Depression in Parkinson's disease:Health risks,etiology,and treatment options[J].Neuropsychiatric Disease&Treatment,2008,4(1):81-91.
[4]尚延昌,王淑辉,王振福,等.普拉克索治疗帕金森病合并抑郁的系统评价[J].现代生物医学进展,2010,10(2):280-283.
[5]Liu J,Dong J,Wang L,et al.Comparative efficacy and acceptability of antidepressants in Parkinson's disease:a network meta-analysis[J].Plos One,2013,8(10):e76651.
[6]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病治疗指南(第三版)[J].药学与临床研究,2014,4:428-433.
[7]李绒.普拉克索治疗老年帕金森病伴发抑郁的疗效观察[J].医学信息,2014,39:383-383.
[8]张运仓.普拉克索治疗帕金森病伴发抑郁障碍的对照研究[J].中国社区医师(医学专业),2012,14(30):185-185.
[9]林向,唐毅,叶云.普拉克索治疗帕金森病伴抑郁的疗效及安全性评价[J].中国实用神经疾病杂志,2014,17(12):98-99.
[10]戴美芬,余丹丽,赵丹,等.普拉克索治疗帕金森病伴抑郁的临床疗效观察[J].中国临床神经科学,2010,18(2):188-194.
[11]朱华伟,齐进兴,邓建中.普拉克索治疗帕金森病伴抑郁的临床效果[J].中国实用神经疾病杂志,2016,19(22):115-116.
[12]李杰.普拉克索治疗帕金森病伴抑郁患者的临床观察[J].河南医学研究,2014,23(3):87-88.
[13]高丽丽,孙德华,陈卫.普拉克索治疗帕金森病合并抑郁疗效观察[J].中国基层医药,2015,22(17):2619-2621.
[14]钱燕群,毛旭强,张剑平,等.普拉克索治疗帕金森病合并抑郁症的随机对照研究[J].现代生物医学进展,2011,s2:5069-5070.
[15]朱宝霞.盐酸普拉克索治疗帕金森病伴发抑郁45例分析[J].中国医药指南,2013,11(23):610-611.
[16]陈菲,黄财城,陈媚丽,等.普拉克索治疗帕金森病伴抑郁的临床效果分析[J].中国卫生标准管理,2016,7(14):83-84.
[17]李琳钰,季兴,张德敏,等.盐酸普拉克索联合美多巴对帕金森病合并抑郁患者的治疗效果分析[J].国际医药卫生导报,2016,22(15):2326-2328.
[18]李华丽,李冬冬,姚艳丽.普拉克索合美多巴治疗帕金森病合并抑郁30例临床观察[J].中国民族民间医药,2014,15:42-42.
[19]苏颖,刘郁东,孙洲,等.普拉克索与氟西汀治疗帕金森病合并抑郁症的随机平行对照研究[J].中华老年医学杂志,2010,29(1):1-4.
[20]方玲,汤义平.普拉克索治疗帕金森病伴发抑郁障碍的对照研究[J].浙江临床医学,2011,13(7):787-789.
[21]邓琦,白鹤,胡霞,等.普拉克索治疗帕金森病合并抑郁的疗效观察[J].现代养生,2014,10:159-160.
[22]马松华.普拉克索治疗帕金森病合并抑郁的疗效观察[J].现代中西医结合杂志,2011,20(3):319-320.
[23]邬至平,黄跃金,曾婷婷,等.普拉克索治疗帕金森病抑郁的临床疗效分析[J].中国高等医学教育,2016,3:134-135.
[24]祝美蓉,徐翠萍.普拉克索对帕金森病伴抑郁患者的临床疗效观察[J].大家健康(学术版),2014,15:85-86.
[25]张深山,叶凯文,高镇松.普拉克索治疗帕金森病伴发抑郁障碍临床疗效与安全性[J].广东医学,2010,31(7):908-910.
[26]Bxarone Paolo,Poewe Werner,Albrecht Stefan,et al.Pramipexole for the treatment of depressive symptoms in patients with Parkinson's disease:a randomised,double-blind,placebocontrolled trial[J].Lancet Neurol,2010,9(6):573-580.
[27]Barone Paolo,Scarzella Leonardo,Marconi Roberto,et al.Pramipexole versus sertraline in the treatment of depression in Parkinson's disease:a national multicenter parallel-group randomized study[J].J Neurol,2006,253(5):601-607.
[28]Kalia Lorraine V,Kalia Suneil K.Disease‐modifying strategies for Parkinson's disease[J].Movement Disorders,2015,30(11):1442-1450.
[29]Shulman LM,Taback RL,Rabinstein AA,et al.Non-recognition of depression and other non-motor symptoms in Parkinson's disease[J].Parkinsonism Relat Disord,2002,8:193-197.
[30]Seppi Klaus,Weintraub Daniel,Coelho Miguel,et al.The Movement Disorder Society Evidence-Based Medicine Review Update:Treatments for the non-motor symptoms of Parkinson's disease[J].Mov Disord,2011,26(Suppl 3):S42-80.