高频左侧重复经颅磁刺激与电休克治疗抑郁症随机对照试验的meta分析
发布时间:2019-01-01 13:47
【摘要】:背景:既往研究对于高频左侧重复经颅磁刺激(HFL-rTMS)和电休克疗法(ECT)的抗抑郁疗效有不同的比较结果,本研究试图通过循证医学的方法系统评价二者的疗效性,并且探讨HFL-rTMS是否能够代替ECT治疗抑郁症。方法:我们在以下数据库中进行了系统的文献检索(PubMed,CCTR,Web of Science,Embase,CBM-disc和CNKI),文献检索日期截止至2012年10月。将有效率和缓解率作为主要评价指标。使用随机效应模型和比值比(ORs)进行统计分析。结果:共筛选出7篇文献,,7项RCTs纳入共262例抑郁患者。全部研究均报道了有效率,其中HFL-rTMS治疗组135人,有67人治疗有效(49.6%);ECT治疗组127人,有78人治疗有效(61.4%)[OR=0.64,95%CI(0.30,1.38),z=1.13,p=0.26]。有6项RCTs报道了痊愈率,其中HFL-rTMS治疗组115人,有39人治疗有效(33.9%);ECT治疗组107人,有47人治疗有效(43.9%)[OR=0.66,95%CI(0.33,1.32),z=1.19,p=0.24]。两组患者间入组时的抑郁评分以及失访率均没有统计差异。没有发现显著的异质性和潜在的发表偏倚。结论:当HFL-rTMS与ECT都作为单一治疗方式时,他们对抑郁症的治疗效果没有统计学差异。但考虑到HFL-rTMS花费更少且副作用少,它可以被期待成为ECT的替代疗法。未来研究应一步探索HFL-rTMS疗效的长期维持,以及HFL-rTMS与其他刺激模式的rTMS的疗效对比,从而寻找最佳的rTMS参数设置。
[Abstract]:Background: previous studies have compared the antidepressant effects of high frequency left side repetitive transcranial magnetic stimulation (HFL-rTMS) with electroshock therapy (ECT). This study attempts to systematically evaluate their efficacy through evidence-based medicine. And to explore whether HFL-rTMS can replace ECT in the treatment of depression. Methods: we conducted systematic literature retrieval in the following databases (PubMed,CCTR,Web of Science,Embase,CBM-disc and CNKI), as of October 2012). Efficiency and mitigation rate as the main evaluation indicators. Stochastic effect model and ratio (ORs) were used for statistical analysis. Results: a total of 7 articles were selected and 7 items of RCTs were included in 262 patients with depression. The effective rate was reported in all the studies, of which there were 135 patients in the HFL-rTMS treatment group, 67 of whom were effective (49.6%). In the ECT treatment group, 78 patients (61.4%) were effective [OR=0.64,95%CI (0.301.38), ZD 1.13p 0.26]. The cure rate was reported by 6 items of RCTs, of which there were 115 cases in HFL-rTMS group and 39 cases were effective (33.9%). In the ECT treatment group, 47 patients were effective (43.9%) [OR=0.66,95%CI (0.33 卤1.32), ZD 1.19 p0. 24]. There was no statistical difference in depression score and loss rate between the two groups. No significant heterogeneity and potential publication bias were found. Conclusion: there was no significant difference in the efficacy of HFL-rTMS and ECT in the treatment of depression. But given the lower cost and less side effects of HFL-rTMS, it could be expected to be an alternative to ECT. The future study should explore the long-term maintenance of the efficacy of HFL-rTMS and the comparison of the efficacy of HFL-rTMS with other stimulation modes of rTMS in order to find the best setting of rTMS parameters.
【学位授予单位】:重庆医科大学
【学位级别】:硕士
【学位授予年份】:2013
【分类号】:R749.41
本文编号:2397655
[Abstract]:Background: previous studies have compared the antidepressant effects of high frequency left side repetitive transcranial magnetic stimulation (HFL-rTMS) with electroshock therapy (ECT). This study attempts to systematically evaluate their efficacy through evidence-based medicine. And to explore whether HFL-rTMS can replace ECT in the treatment of depression. Methods: we conducted systematic literature retrieval in the following databases (PubMed,CCTR,Web of Science,Embase,CBM-disc and CNKI), as of October 2012). Efficiency and mitigation rate as the main evaluation indicators. Stochastic effect model and ratio (ORs) were used for statistical analysis. Results: a total of 7 articles were selected and 7 items of RCTs were included in 262 patients with depression. The effective rate was reported in all the studies, of which there were 135 patients in the HFL-rTMS treatment group, 67 of whom were effective (49.6%). In the ECT treatment group, 78 patients (61.4%) were effective [OR=0.64,95%CI (0.301.38), ZD 1.13p 0.26]. The cure rate was reported by 6 items of RCTs, of which there were 115 cases in HFL-rTMS group and 39 cases were effective (33.9%). In the ECT treatment group, 47 patients were effective (43.9%) [OR=0.66,95%CI (0.33 卤1.32), ZD 1.19 p0. 24]. There was no statistical difference in depression score and loss rate between the two groups. No significant heterogeneity and potential publication bias were found. Conclusion: there was no significant difference in the efficacy of HFL-rTMS and ECT in the treatment of depression. But given the lower cost and less side effects of HFL-rTMS, it could be expected to be an alternative to ECT. The future study should explore the long-term maintenance of the efficacy of HFL-rTMS and the comparison of the efficacy of HFL-rTMS with other stimulation modes of rTMS in order to find the best setting of rTMS parameters.
【学位授予单位】:重庆医科大学
【学位级别】:硕士
【学位授予年份】:2013
【分类号】:R749.41
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