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帕利哌酮缓释片与阿立哌唑治疗精神分裂症效果比较的Meta分析

2020-10-09李艳巴文强袁也丰

中国当代医药 2020年24期
关键词:阿立哌唑Meta分析精神分裂症

李艳 巴文强 袁也丰

[摘要]目的 采用Meta分析方法比較帕利哌酮缓释片与阿立哌唑治疗精神分裂症的效果及不良反应。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library数据库,收集帕利哌酮缓释片与阿立哌唑治疗精神分裂症的随机对照试验(RCTs)。检索时间为建库至2019年10月。使用RevMan 5.3软件进行Meta分析。结果 最终共纳入22篇RCTs文献。Meta分析显示,治疗第2周末和第4周末帕利哌酮缓释片组患者的阳性和阴性症状量表(PANSS)总分减分情况优于阿立哌唑组,差异有统计学意义[第2周末:MD=-8.43,95%CI(-14.61,-2.26),P=0.007;第4周末:MD=-5.23,95%CI(-9.57,-0.89),P=0.02]。治疗第8周末,两组患者的PANSS总分[MD=-5.47,95%CI(-11.31,-0.38),P=0.07]、阳性症状评分[MD=-2.49,95%CI(-7.33,2.34),P=0.31]、一般精神病理症状评分[MD=-1.43,95%CI(-5.99,3.12),P=0.54]比较,差异无统计学意义;帕利哌酮缓释片组患者的阴性症状评分减分情况优于阿立哌唑组,差异有统计学意义[MD=-1.18,95%CI(-2.10,-0.26),P=0.01];帕利哌酮缓释片组患者的催乳素水平高于阿立哌唑组,差异有统计学意义[MD=31.39,95%CI(13.62,49.15),P=0.0005]。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 帕利哌酮缓释片治疗精神分裂症的效果与阿立哌唑相似,但起效更快,对阴性症状的改善效果更好。两者的不良反应发生率相似,但帕利哌酮缓释片会升高患者血清催乳素水平。

[关键词]帕利哌酮缓释片;阿立哌唑;精神分裂症;Meta分析

[中图分类号] R749          [文献标识码] A          [文章编号] 1674-4721(2020)8(c)-0027-06

[Abstract] Objective To compare the effect and adverse reactions of Paliperidone Sustained-release Tablets and Aripiprazole in the treatment of schizophrenia by Meta-analysis. Methods Randomized controlled trials (RCTs) related to the Paliperidone Sustained-release Tablets and Aripiprazole in the treatment of patients with schizophrenia were searched in China National Knowledge Infrastructure, Wanfang, Weipu Database, Chinese Biomedical Literature Service System, PubMed, Embase, Cochrane Library databases. Search time was from the establishment of the database to October 2019. Meta-analysis was carried out with RevMan 5.3 software. Results Finally, a total of 22 RCTs literatures were included. Meta-analysis showed that compared with the Aripiprazole group, the reduction of total score of positive and negative symptoms scale (PANSS) in the Paliperidone Sustained-release Tablets group was better after 2 and 4 weeks of treatment, and the differences were statistically significant (after 2 weeks of treatment: MD=-8.43, 95%CI[-14.61, -2.26], P=0.007; after 4 weeks of treatment: MD=-5.23, 95%CI[-9.57,-0.89], P=0.02). After 8 weeks of treatment, there were no significant differences in the PANSS score (MD=-5.47, 95%CI[-11.31, -0.38], P=0.07), positive symptoms score (MD=-2.49, 95%CI[-7.33, 2.34], P=0.31), and the general psychotic symptoms score (MD=-1.43, 95%CI[-5.99, 3.12], P=0.54) between the two groups. Compared with Aripiprazole group, the reduction of negative symptoms score of Paliperidone Sustained-release Tablets group was better, and the difference was statistically significant (MD=-1.18, 95%CI[-2.10, -0.26], P=0.01). The prolactin level in the Paliperidone Sustained-release Tablets group was higher than that in the Aripiprazole group, and the difference was statistically significant (MD=31.39, 95%CI[13.62, 49.15], P=0.0005). There was no significant difference in the incidence of adverse reactions between the two groups of patients (P>0.05). Conclusion Paliperidone Sustained-release Tablets are as effective as Aripiprazole in the treatment of schizophrenia. However, it has faster onset and much better effect for the negative symptoms. The incidence of adverse reactions between the two drugs is similar, but Paliperidone Sustained-release Tablets can increase the serum prolactin level of patients.

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(收稿日期:2020-03-06)

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