米氮平辅助治疗精神分裂症阴性症状疗效与安全性Meta分析

发布时间：2018-05-12 07:14

本文选题：米氮平 + 精神分裂症　；参考：《重庆医科大学》2014年硕士论文

【摘要】：背景和目的：目前关于米氮平联合抗精神病药物针对精神分裂症阴性症状的治疗效果尚无定论，缺乏有效的证据。为了更全面系统地了解该药物合并使用对精神分裂症患者的阴性症状的疗效，本研究通过循证医学方法为精神分裂症特别是阴性症状的临床治疗提供科学依据。方法：通过系统检索截止2012年10月份的Pubmed、Embase、中国知网、万方等相关数据库，共检索到关于选择米氮平辅助治疗精神分裂症阴性症状患者疗效及其安全性的随机对照或临床对照试验的相关文献共4704篇，按照纳入和排除标准进行筛选后，最终纳入8项随机对照试验。首先，按照Jadad改良量表的标准，由两个人独立对相关文献分别进行质量评价；然后，根据Meta分析的森林图法对异质性进行检测，并采取合适的效应模型检验合并效应量；最后，利用敏感性分析和漏斗图法对存在的偏倚进行检测。结果：米氮平联合抗精神病药物治疗精神分裂症阴性症状的有效率（OR=3.75[2.73,5.16]）和痊愈率（OR=2.21[1.23,3.99]）明显要高于单独使用抗精神病药物治疗组。总体上看米氮平联合抗精神病药物组的不良发生率与单独使用抗精神病药物组差别没有统计学意义（P0.05），除实验组恶心与失眠这两项副反应的发生率明显低于对照组（P0.05）；嗜睡这一副反应发生率低于单用抗精神病药物组（P0.05），，只有失眠的发生率明显低于单用抗精神病药物组（P0.01）。结论：米氮平联合抗精神病药物对于精神分裂症阴性症状的治疗具有明显的效果，同时，联合用药并未显著增加常见的抗精神药物所带来的副反应发生率。
[Abstract]:Background and objective: at present, there is no conclusion on the efficacy of metozapine combined with antipsychotics in the treatment of negative symptoms of schizophrenia. In order to understand the efficacy of the combined use of the drug on the negative symptoms of schizophrenia, this study provides a scientific basis for the clinical treatment of schizophrenia, especially negative symptoms, through the method of evidence-based medicine. Methods: the relevant databases such as Pubmedum Embase, China knowledge Network, Wanfang and so on, were searched systematically by means of systematic search for the month of October, 2012, etc. A total of 4704 articles of randomized controlled or clinical controlled trials on the efficacy and safety of metozapine in adjuvant treatment of schizophrenia with negative symptoms were retrieved and screened according to the inclusion and exclusion criteria. Finally, 8 randomized controlled trials were included. First of all, according to the standard of Jadad improvement scale, two people independently evaluate the quality of relevant literature. Then, according to the forest map method of Meta analysis, the heterogeneity is tested, and the appropriate effect model is adopted to test the combined effect quantity. Sensitivity analysis and funnel graph were used to detect the bias. Results: the effective rate of metozapine combined with antipsychotics in the treatment of schizophrenia negative symptoms was 3.75 [2.735.16] and the cure rate was 2.21 [1.233.99], which was significantly higher than that in the group treated with antipsychotic drugs alone. On the whole, there was no significant difference in the incidence of adverse effects between the metozapine combined with antipsychotics group and the antipsychotic drug group alone (P 0.05). The incidence of adverse reactions except nausea and insomnia in the experimental group was significantly lower than that in the control group. The incidence of somnolence was lower than that of single antipsychotics group, and the incidence of insomnia was significantly lower than that of single antipsychotics group. Conclusion: metozapine combined with antipsychotics has obvious effect on the treatment of negative symptoms of schizophrenia, and the incidence of side effects caused by common antipsychotic drugs has not been significantly increased by the combination of mizapine and antipsychotic drugs.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3

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