度洛西汀联合非典型抗精神病药治疗躯体形式障碍Meta分析

发布时间：2018-07-10 05:50

本文选题：度洛西汀 + 联合治疗　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:通过Meta分析的方法评价度洛西汀联合非典型抗精神病药对比度洛西汀单药治疗躯体形式障碍的疗效和安全性。方法:以度洛西汀、躯体形式障碍、躯体症状障碍为检索词。检索Cochrane Library、Pubmed、中国知网、万方等。纳入度洛西汀联合非典型抗精神病药治疗躯体形式障碍,观察对象符合现有的躯体形式障碍诊断标准的临床随机对照实验。对纳入研究采用Cochrane风险偏倚评估工具进行质量评价,然后提取资料,采用RevMan5.3软件进行Meta分析。结果:共纳入10篇随机对照试验,其中4篇为度洛西汀联合喹硫平对比单药度洛西汀,2篇联合氨磺必利对比单药,2篇联合奥氮平对比单药,1篇联合帕利哌酮对比单药,1篇联合阿立哌唑对比单药。使用Meta分析对患者躯体形式障碍治疗的有效率、治愈率,汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、症状自评量表(SCL-90)中躯体化因子进行评估,结果显示治疗后联合组有效率(RR 1.29,95%CI[1.19-1.40])、治愈率(RR 1.66,95%CI[1.26-2.19])明显高于单药组,HAMD(MD-4.47,95%CI[-5.16,-3.77])、HAMA(MD-3.44,95%CI[-4.16,-2.73])评分、躯体化因子分(MD-0.44,95%CI[-0.55,-0.33])明显低于单药组,TESS副反应(恶心、嗜睡、头晕、口干、乏力、食欲减退等)与单药治疗相当。结论:本研究说明度洛西汀与以上5种非典型抗精神病药联合治疗躯体形式障碍的疗效优于度洛西汀单药治疗。不良反应与单药治疗相当。由于非典型抗精神病药种类多,纳入研究少,还须要更多高质量的研究。
[Abstract]:Objective: to evaluate the efficacy and safety of duloxetine combined with atypical antipsychotics in the treatment of somatoform disorders by meta-analysis. Methods: Doxetine, somatoform disorder and somatic symptom disorder were used as the key words. Search for Cochrane Library Pubmed. China knowledge Web, Wanfang et al. Doxetine combined with atypical antipsychotics was used to treat somatoform disorder. Cochrane risk bias assessment tool was used to evaluate the quality of the inclusion study. Then the data were extracted and Meta-analysis was carried out with Revman 5.3 software. Results: a total of 10 randomized controlled trials were conducted. Four of them were duloxetine combined with quinthiapine, single drug, ampicillin, olanzapine, single drug, palipiperone, single drug, combined with aripiprazole, single drug, single drug. The efficacy, cure rate, Hamilton Depression scale (HAMD-17), Hamilton anxiety scale (Hama), symptom Checklist 90 (SCL-90) and somatization factors were evaluated by Meta-analysis. The results showed that the effective rate (RR 1.2995 CI [1.19-1.40]), the cure rate (RR 1.6695 CI [1.26-2.19]) were significantly higher in the combined group than in the single drug group (MD-4.47 卤95CI [-5.16 -3.77]). The score of somatization factor (MD-0.4495 CI [-0.55U -0.33]) was significantly lower than that in the monotherapy group (nausea, sleepiness, dizziness, fatigue, fatigue), and the score of somatization factor (MD-0.4495 CI [-0.55U -0.33]) was significantly lower than that in the monotherapy group (nausea, sleep, dizziness, fatigue). Loss of appetite, etc.) is comparable to single drug therapy. Conclusion: this study shows that the combination of doxicetine and the above five atypical antipsychotics for somatoform disorder is better than that of doloxetine alone in the treatment of somatoform disorder. Adverse reactions were comparable to single drug therapy. Because atypical antipsychotics have a large variety of drugs and few studies are included, more high-quality studies are needed.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749

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