氯氮平片联合利培酮片治疗难治性精神分裂症安全性的系统评价

发布时间：2018-04-20 02:25

本文选题：氯氮平 + 利培酮　；参考：《中国临床药理学杂志》2017年18期

【摘要】：目的系统评价氯氮平片联合利培酮片治疗难治性精神分裂症的安全性。方法电子检索Medline、Em Base、中国生物医学文献数据库等中英文数据库,截至2016-11-30。纳入关于氯氮平合并利培酮治疗难治性精神分裂症的随机对照试验(RCT)、半RCT(Quasi-RCT),试验组予以氯氮平联合利培酮治疗,对照组予氯氮平治疗。依据Cochrane 5.1.0版质量评价标准评价研究质量和提取数据进行Meta分析。结果共纳入9个研究,共计781例患者。Meta分析结果显示:氯氮平联合利培酮治疗难治性精神分裂症的安全性较高,在便秘、流涎、嗜睡、头晕、白细胞减少、心动过速、心电图异常等7个方面的药物不良反应发生率合用组均低于单用组(P0.05),在肌张力增高、静坐不能、震颤等3个药物不良反应方面组间差异无统计学意义(P0.05)。结论氯氮平联合利培酮治疗难治性精神分裂症不是简单的药物叠加,可减少单用时因剂量过高导致的药物不良反应,安全性较高,可作为难治性分裂症治疗的策略之一。
[Abstract]:Objective to evaluate the safety of clozapine combined with risperidone in the treatment of refractory schizophrenia. Methods to search the Chinese and English databases such as Medlinesite Em Base, Chinese Biomedical Literature Database and so on, as of June 11, 30, 2016. The randomized controlled trial of clozapine combined with risperidone in the treatment of refractory schizophrenia was conducted in RCTX and semi-RCTA Quasi-RCTA. The experimental group was treated with clozapine combined with risperidone and the control group was treated with clozapine. According to the quality evaluation standard of Cochrane 5.1.0, the research quality was evaluated and the extracted data were analyzed by Meta. Results A total of 781 patients. Meta-analysis showed that clozapine combined with risperidone was more safe in constipation, salivation, drowsiness, dizziness, leukopenia, tachycardia. The incidence of adverse drug reactions in the combination group was lower than that in the single use group (P 0.05). There was no significant difference among the three groups in terms of muscle tension, sedentary inability, tremor and other adverse drug reactions. Conclusion clozapine combined with risperidone is not a simple drug superposition for refractory schizophrenia, it can reduce the adverse drug reaction caused by excessive dosage in single use, and it is safe and can be used as one of the strategies for the treatment of refractory schizophrenia.
【作者单位】：河北省第六人民医院心身疾病科;
【基金】：河北省青年基金资助项目(20120254)
【分类号】：R749.3

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