MECT联合SSRI类药物治疗难治性抑郁症有效性和安全性Meta分析

发布时间：2018-12-16 14:54

【摘要】：目的:评价改良电休克(modified electroconvulsive therapy,MECT)联合选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)治疗难治性抑郁症的有效性和安全性。方法:通过检索Cochrane Library、PubMed、Web of Knowledge、EBSCO、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP),检索年限不限,筛选随机对照试验(randomized controlled trials,RCTs),并对纳入文献进行质量评价和数据提取,用Review manager 5.0软件对纳入的RCTs进行Meta分析。结果:纳入7个RCTs共461名患者,其中MECT联合治疗组230例,SSRI药物治疗组231例。Meta分析结果指出MECT联合治疗组患者治愈率和有效率均高于SSRI药物治疗组,差异具有统计学意义(分别为治愈率Z=4.52,P=0.000;有效率Z=7.71,P=0.000),且副反应中MECT联合治疗组中近事记忆障碍的发生率要高于SSRI药物治疗组(P=0.013),其余的副反应发生率比较均无统计学意义(P0.05)。结论:与单独SSRI药物治疗相比,MECT联合SSRI治疗可明显提高难治性抑郁症患者的有效率和治愈率,具有临床指导意义。
[Abstract]:Aim: to evaluate the efficacy and safety of modified electroshock (modified electroconvulsive therapy,MECT) combined with selective serotonin reuptake inhibitor (selective serotonin reuptake inhibitor,SSRI) in the treatment of refractory depression. Methods: by searching Cochrane Library,PubMed,Web of Knowledge,EBSCO, Chinese biomedical literature database (CBM), Chinese academic journal full text database (CNKI), Wanfang database (CECDB), Weipu full text database of Chinese science and technology journal (CQVIP), The search time was unlimited, the random controlled trial (randomized controlled trials,RCTs) was screened, and the quality evaluation and data extraction of the literature were carried out, and the RCTs was analyzed by Meta with Review manager 5.0 software. Results: a total of 461 RCTs patients were included, including 230 cases in MECT combined treatment group and 231 cases in SSRI drug treatment group. The results of Meta analysis showed that the cure rate and effective rate of MECT combined treatment group were higher than that of SSRI drug treatment group. The difference was statistically significant (the cure rate was 4.52 P 0.000 respectively; The effective rate was 7.71% (P < 0.05), and the incidence of near-event memory disorder in MECT combined treatment group was higher than that in SSRI group (P 0.013). There was no significant difference in the incidence of other side effects (P0.05). Conclusion: compared with SSRI alone, MECT combined with SSRI can significantly improve the effective rate and cure rate of patients with refractory depression.
【作者单位】：重庆医科大学附属第一医院神经内科;
【基金】：国家重点基础研究发展计划资助项目(973计划)(编号:2009CB918302)
【分类号】：R749.4

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