吗氯贝胺与米帕明治疗抑郁症对照研究的Meta分析

Comparative Study on Moclobemide and Imipramine in the Treatment of Depression--A meta-analysis

目的 :进一步认识吗氯贝胺与米帕明治疗抑郁症的临床疗效和不良反应差异。方法 :收集国内医药杂志上公开发表的 9篇吗氯贝胺与米帕明治疗抑郁症对照研究论文 ,作Meta分析。结果 :吗氯贝胺自身对照比较 :综合检验Z1=5 1.5 4(P <0 .0 1) ,提示吗氯贝胺治疗抑郁症前后症状变化差异有非常显著性。 d1=3 .2 0 ,表明治疗效应极大。与米帕明的组间比较 :Z2 =- 0 .2 3(P >0 .0 5 ) ,提示两种药物的疗效差异无显著性 , d2 =0 .2 8,表明这种差异效应偏小。吗氯贝胺组致失眠显著多于米帕明组 (χ2 =2 .6 5 ,P <0 .0 5 ) ,但这种差异的强度偏小 (d =0 .2 9) ,比值比为 2 .2 8。吗氯贝胺组致口干、视物模糊、便秘、心功异常、疲倦等不良反应显著少于米帕明组 ,差异有显著性 (P <0 .0 5或 0 .0 1) ,且强度较明显 (d =0 .44～ 0 .76 ) ,比值比 3.6 9～ 17.43。结论 :吗氯贝胺与米帕明平均 4周疗效差异无显著性 。

To study the difference in therapeutic effects and adverse reactions between moclobemide(Moc) and imipramine(Imi), meta analysis was made on 9 published papers on comparative study of Moc and Imi. Our results showed that the significant difference was found in symptom before and after treatment( P<0.01 ). No difference was revealed in therapeutic effect between Moc group and Imi group after treatment with the two drugs( P>0.05 ). Drug adverse reactions such as dry mouth, blurred vision, constipation , abnormality of heart function was significantly lower in Moc group that in Imi group( P<0.05 ). It is concluded that in a period of 4 weeks, there was no significant difference in efficacy but the adverse reactions coused by Moc were much less than those by Imi.