盐酸安非他酮和盐酸氟西汀治疗抑郁症的有效性及安全性的Meta分析
|
摘要
目的:系统评价盐酸安非他酮缓释片和盐酸氟西汀片治疗抑郁症的有效性及安全性,为其临床应用提供依据。方法:计算机检索Cochrane图书馆临床对照试验资料库、Ovid-medline全文数据库、PubMed、Embase、中国期刊全文数据库、万方数字化期刊库、维普数据库和中国生物医学文献数据库中盐酸安非他酮缓释片对比盐酸氟西汀片治疗抑郁症的有效性与安全性的随机对照试验(RCT),提取资料后采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入9项RCT,合计1 106例患者。Meta分析,盐酸安非他酮缓释片与盐酸氟西汀片治疗抑郁症的有效性无明显差异[OR=1.13,95%CI(0.87,1.48),P>0.05];不良反应发生率与盐酸氟西汀片治疗抑郁症比较也无明显差异[OR=1.13,95%CI(0.91,1.41),P>0.05]。结论:盐酸安非他酮缓释片和盐酸氟西汀片治疗抑郁症具有相似的疗效及不良反应。
Objective To approach the effectiveness and safety of bupropion hydrochloride sustained-release tablets and fluoxetine tablets in treatment of depression,and to provide basis for their application in clinic.Methods Computer search was performed using the Cochrane Central Register of Controlled Trial,Ovid-medline,PubMed,Embase,CNKI, WanFang, VIP,and CBM,and the randomized controlled trials(RCTs) were collected,then the retrieved studied according to predefined inclusion and exclusion criteria were screened,the quality of included studies was evaluated and RevMan 5.3software was used for Meta-analysis.Results A total of9 RCT and 1 106 patients were finally included.There was no difference in the effectiveness between bupropion hydrochloride sustained-release tablets and fluoxetine tablets [OR=1.13,95%CI(0.87,1.48),P>0.05].There was no difference in the side effects between bupropion hydrochloride sustained-release tablets and fluoxetine tablets[OR=1.13,95%CI(0.91,1.41),P>0.05].Conclusion Bupropion hydrochloride sustained-release tablets have the same effectiveness and side effects as fluoxetine tablets in treatment of depression.
Objective To approach the effectiveness and safety of bupropion hydrochloride sustained-release tablets and fluoxetine tablets in treatment of depression,and to provide basis for their application in clinic.Methods Computer search was performed using the Cochrane Central Register of Controlled Trial,Ovid-medline,PubMed,Embase,CNKI, WanFang, VIP,and CBM,and the randomized controlled trials(RCTs) were collected,then the retrieved studied according to predefined inclusion and exclusion criteria were screened,the quality of included studies was evaluated and RevMan 5.3software was used for Meta-analysis.Results A total of9 RCT and 1 106 patients were finally included.There was no difference in the effectiveness between bupropion hydrochloride sustained-release tablets and fluoxetine tablets [OR=1.13,95%CI(0.87,1.48),P>0.05].There was no difference in the side effects between bupropion hydrochloride sustained-release tablets and fluoxetine tablets[OR=1.13,95%CI(0.91,1.41),P>0.05].Conclusion Bupropion hydrochloride sustained-release tablets have the same effectiveness and side effects as fluoxetine tablets in treatment of depression.
引文
[1]徐桂娟.心血管疾病与抑郁障碍:共病概念引出的新问题[J].中国临床康复,2005,9(11):146-147.
[2]朱秀梅,陈志诚,黄伟侨,等.高效液相色谱法测定人血浆中安非他酮浓度[J].海峡药学,2013,25(11):191-194.
[3]中华医学会精神科分会.中国精神障碍诊断分类与标准[M].济南:山东科技出版社,2001:118.
[4]张明园.精神科评定量表手册[M].湖南:湖南科学技术出版社,1998:121.
[5]Sackett DL,Clarke M,Oxman AD,et al.Cochrane Reviewers,Handbook 4.2,In Renew Manager[M].Versions 4.2.England:The Cochrane Collaboration,2002:13.
[6]Jadad AR,Moore A,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1.
[7]德英,洪旗,刘关键,等.Meta分析中发表性偏倚的识别与处理[J].中国循证医学杂志,2003,3(1):45.
[8]周旭毓,方积乾.Meta分析的常见偏倚[J].循证医学,2002,2(4):216.
[9]李婷,李含秋,王西林,等.盐酸安非他酮缓释片治疗抑郁症的随机、双盲、平行对照的多中心临床研究[J].中国医药指南,2012,10(24):121-124.
[10]徐国洪,黄少平.盐酸安非他酮与盐酸氟西汀治疗抑郁症的临床研究[J].中国医药指南,2011,9(33):120-121.
[11]马金芸,陈晋东,况伟宏,等.盐酸安非他酮与盐酸氟西汀治疗抑郁症伴焦虑症状的对照研究[J].复旦学报:医学版,2008,35(2):252-256.
[12]吉明安.安非他酮与氟西汀治疗抑郁症对照研究[J].临床心身疾病杂志,2008,14(5):449-450.
[13]沈一峰,李华芳,孙学礼,等.安非他酮缓释片治疗抑郁症的随机双盲多中心临床试验[J].中国临床药学杂志,2008,17(3):136-140.
[14]郭建雄,杜文佳,王西林,等.安非他酮缓释片治疗抑郁症对照研究[J].临床心身疾病杂志,2007,13(4):323-324.
[15]王雪,张波,李静,等.盐酸安非他酮缓释片治疗抑郁症的双盲双模拟随机对照试验[J].中国循证医学杂志,2007,7(6):409-414.
[16]李冠军,李华芳,沈晓玲.盐酸安非他酮缓释片治疗抑郁症的随机、双盲、双模拟平行对照研究[J].上海精神医学,2005,17(3):160-162.
[17]李华芳,赵靖平,况伟宏,等.安非他酮缓释片治疗抑郁症72例的随机双盲双模拟多中心临床研究[J].中国新药与临床杂志,2005,24(8):614-618.
[18]Nieuw strat en CE,Dolov ich LR.Bupropion versus selective serotonin reuptake inhibitors for treatment of depression[J].Ann Pharmacother,2001,35(12):1608.
[19]张二箭,田福利,张宾.心血管疾病与焦虑及抑郁症关系研究进展[J].人民军医,2012,55(11):1123-1125.
[20]Tonelli MR.The limits of evidence based medicine[J].Respir Care,2001,46(12):1435-1440.
[2]朱秀梅,陈志诚,黄伟侨,等.高效液相色谱法测定人血浆中安非他酮浓度[J].海峡药学,2013,25(11):191-194.
[3]中华医学会精神科分会.中国精神障碍诊断分类与标准[M].济南:山东科技出版社,2001:118.
[4]张明园.精神科评定量表手册[M].湖南:湖南科学技术出版社,1998:121.
[5]Sackett DL,Clarke M,Oxman AD,et al.Cochrane Reviewers,Handbook 4.2,In Renew Manager[M].Versions 4.2.England:The Cochrane Collaboration,2002:13.
[6]Jadad AR,Moore A,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1.
[7]德英,洪旗,刘关键,等.Meta分析中发表性偏倚的识别与处理[J].中国循证医学杂志,2003,3(1):45.
[8]周旭毓,方积乾.Meta分析的常见偏倚[J].循证医学,2002,2(4):216.
[9]李婷,李含秋,王西林,等.盐酸安非他酮缓释片治疗抑郁症的随机、双盲、平行对照的多中心临床研究[J].中国医药指南,2012,10(24):121-124.
[10]徐国洪,黄少平.盐酸安非他酮与盐酸氟西汀治疗抑郁症的临床研究[J].中国医药指南,2011,9(33):120-121.
[11]马金芸,陈晋东,况伟宏,等.盐酸安非他酮与盐酸氟西汀治疗抑郁症伴焦虑症状的对照研究[J].复旦学报:医学版,2008,35(2):252-256.
[12]吉明安.安非他酮与氟西汀治疗抑郁症对照研究[J].临床心身疾病杂志,2008,14(5):449-450.
[13]沈一峰,李华芳,孙学礼,等.安非他酮缓释片治疗抑郁症的随机双盲多中心临床试验[J].中国临床药学杂志,2008,17(3):136-140.
[14]郭建雄,杜文佳,王西林,等.安非他酮缓释片治疗抑郁症对照研究[J].临床心身疾病杂志,2007,13(4):323-324.
[15]王雪,张波,李静,等.盐酸安非他酮缓释片治疗抑郁症的双盲双模拟随机对照试验[J].中国循证医学杂志,2007,7(6):409-414.
[16]李冠军,李华芳,沈晓玲.盐酸安非他酮缓释片治疗抑郁症的随机、双盲、双模拟平行对照研究[J].上海精神医学,2005,17(3):160-162.
[17]李华芳,赵靖平,况伟宏,等.安非他酮缓释片治疗抑郁症72例的随机双盲双模拟多中心临床研究[J].中国新药与临床杂志,2005,24(8):614-618.
[18]Nieuw strat en CE,Dolov ich LR.Bupropion versus selective serotonin reuptake inhibitors for treatment of depression[J].Ann Pharmacother,2001,35(12):1608.
[19]张二箭,田福利,张宾.心血管疾病与焦虑及抑郁症关系研究进展[J].人民军医,2012,55(11):1123-1125.
[20]Tonelli MR.The limits of evidence based medicine[J].Respir Care,2001,46(12):1435-1440.