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艾司西酞普兰与帕罗西汀治疗老年抑郁症患者疗效与安全性比较的 Meta分析
杨黎董宪喆崔晓辉段冬梅张兰
0
()
摘要:
目的 系统评价艾司西酞普兰对比帕罗西汀治疗老年抑郁患者的疗效与安全性,为临床 治疗老年抑郁症患者的药物选择提供循证参考。方法 通过计算机检索中国期刊全文数据库(CNKI)、 万方数据库、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、PubMed 及The Cochrane Library,收集艾司西酞普兰(试验组)对比帕罗西汀(对照组)治疗老年抑郁患者的随机对照试验(RCT), 对符合纳入标准的研究进行资料提取和质量评价后,采用Rev Man5.3统计软件进行Meta分析。结局指 标包括汉密尔顿抑郁量表(HAMD)评分、老年抑郁量表(GDS)评分、痊愈率、显效率、不良反应(口干、头 晕、头疼、恶心、食欲不振、疲倦、嗜睡、心动过速、便秘)发生率。结果 共纳入10项RCT,共计823例患 者。Meta分析结果显示,试验组患者痊愈率(OR=1.83,95%CI:1.26~2.65)、HAMD评分(OR=-2.80,95%CI: -3.50~-2.11)、GDS评分(OR=-2.03,95%CI:-3.12~-0.93)、总不良反应发生率(OR=0.45,95%CI:0.36~0.58)、 口干发生率(OR=0.32,95%CI:0.15~0.69,)、头晕发生率(OR=0.38,95%CI:0.17~0.86)、食欲不振发生 率(OR=0.35,95%CI:0.16~0.79)、恶心发生率(OR=0.40,95%CI:0.24~0.69)、头疼发生率(OR=0.36,95% CI:0.14~0.95)、疲倦发生率(OR=0.39,95% CI:0.19~0.80)、便秘发生率(OR=0.34,95% CI:0.17~0.69)均 显著低于对照组,差异均有统计学意义(均P<0.05)。试验组患者显效率(OR=0.91,95% CI:0.63~1.31, P=0.62)、嗜睡发生率(OR=0.57,95% CI:0.22~1.50, P=0.26)、心动过速发生率(OR=0.38,95% CI:0.14~1.02, P=0.05)与对照组比较,差异均无统计学意义。结论 现有证据表明,艾司西酞普兰对比帕罗西汀治疗 老年抑郁症患者,在疗效与安全性方面均具有一定优势。
关键词:  抑郁症  艾司西酞普兰  帕罗西汀  疗效  安全性
DOI:10.3969/j.issn.1009-6574.2020.11.004
基金项目:北京市医院管理中心“登峰”计划专项(DFL20190803);首都科技领军人才培养工程项 目(Z191100006119017);国家自然科学基金(81674082)
Meta-analysis of the efficacy and safety of escitalopram versus paroxetine in elderly patients withdepression
Yang Li, Dong Xianzhe, Cui Xiaohui, Duan Dongmei, Zhang Lan
()
Abstract:
Objective To systematically evaluate the efficacy and safety of escitalopram compared with paroxetine in the treatment of elderly patients with depression, so as to provide evidence-based reference for drug selection in the treatment of elderly patients with depression. Methods By retrieving from China National Knowledge Infrastructure( CNKI), Wanfang database, China Biology Medicine( CBM) database, VIP database, PubMed and The Cochrane Library, randomized controlled trials( RCTs) of escitalopram( experimental group) campared with paroxetine( control group) in the treatment of elderly patients with depression were collected. After the data extraction and quality evaluation of the studies meeting the inclusion criteria, the Rev Man 5.3 statistical software was used for meta-analysis. Rusults A total of 10 RCTs involving 823 patients were included. Meta-analysis results showed that, in the experimental group, the recovery rate( OR=1.83, 95%CI: 1.26-2.65), HAMD score( OR=-2.80, 95%CI:-3.50--2.11), GDS score( OR=-2.03, 95%CI:-3.12--0.93), total adverse reaction rate( OR=0.45, 95%CI:0.36-0.58), the incidence of xerostomia( OR=0.32, 95%CI: 0.15-0.69), The incidence of dizziness( OR=0.38,95%CI:0.17-0.86), the incidence of anorexia( OR=0.35, 95%CI:0.16-0.79), the incidence of nausea( OR=0.40,95%CI:0.24-0.69), the incidence of headache (OR=0.36, 95%CI: 0.14-0.95), the incidence of fatigue( OR=0.39, 95%CI: 0.19-0.80), The incidence of constipation( OR=0.34, 95%CI:0.17-0.69) were significantly lower than the control group, and the differences were statistically significan(t all P<0.05). In the experimental group, the significant effective rate( OR=0.91, 95%CI: 0.63-1.31,P=0.62), the incidence of drowsiness( OR=0.57, 95%CI: 0.22-1.50,P=0.26) and the incidence of tachycardia( OR=0.38, 95%CI: 0.14-1.02,P=0.05) had no statistically significant differences compared with those in the control group. Conclusions Existing evidence shows that escitalopram has certain advantages in efficacy and safety compared with paroxetine in the treatment of elderly patients with depression.
Key words:  Depressive disorder  Escitalopram  Paroxetine  Efficacy  Safety

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