帕罗西汀联合小剂量喹硫平治疗抑郁症有效性与安全性的 Meta 分析

摘要

Objective To evaluate the effect and safety of paroxetine combined with small - dose quetiapine for the treatment of depression. Methods We searched the PubMed,EMBASE,Cochrane Library,CNKI,CBM,VIP and Wanfang data from their es-tablishment to September 1st 2015 to select the trails that investigated the effect and safety of paroxetine combined with small - dose quetiapine in depression. We used the modified Jadad score to assess the quality of research,and then extract the outcomes such as clinical efficacy rate,recovery rate and adverse reactions,and the meta - analysis was done using Stata/ SE 12. 0 software. Results 24 trails with a total of 1678 cases were included,and all included studies were low overall quality. The meta - analysis showed that the group of paroxetine combined with small - dose quetiapine had higher clinical efficacy rate[RR = 1. 13,95% CI(1. 04,1. 24)]and clinical cure rate[RR = 1. 37,95% CI(1. 16,1. 60)]when comparing with the group of paroxetine. However,no significant difference was found in the adverse reactions between the two groups[RR = 1. 22,95% CI(0. 97,1. 54)]. Conclusion The effect of paroxetine combined with small - dose quetiapine in treating depression is superior to the single use of paroxetine,and the combined therapy does not increase the adverse drug reactions.%目的：系统评价帕罗西汀联合小剂量喹硫平治疗抑郁症的有效性与安全性。方法计算机检索PubMed、EMBASE、Cochrane Library、CNKI、CBM、VIP 和万方数据库，并手工检索相关文献，检索时间从各数据库建库至2015年9月1日，纳入帕罗西汀联合小剂量喹硫平治疗抑郁症的相关文献，根据纳入排除标准筛选文献并按照改良后的 Jadad 评分量表评估各研究方法学质量，提取治疗有效率、痊愈率及不良反应等相关数据，采用Stata/ SE 12.0软件进行 Meta 分析。结果纳入随机对照试验（ RCT）24个，共1678例，所有纳入研究总体质量均较低。Meta分析结果显示，帕罗西汀联合小剂量喹硫平对抑郁症的有效率[RR ＝1.13，95％ CI（1.04，1.24）]及治愈率[RR＝1.37，95％ CI（1.16，1.60）]均优于单用帕罗西汀；在不良反应方面，二者差异无统计学意义[ RR ＝1.22，95％ CI （0.97，1.54）]。结论帕罗西汀联合小剂量喹硫平治疗抑郁症的有效性优于单用帕罗西汀，且联合用药未增加药物的不良反应。