西酞普兰与氯米帕明治疗强迫症Meta分析

Meta-analysis of comparative study on citalopram and clomipramine in the treatment of obsessive-compulsive disorder

目的:探讨西酞普兰与氯米帕明治疗强迫症的疗效及不良反应的差异。方法:用Meta分析对9项西酞普兰与氯米帕明治疗强迫症对照研究进行再分析。结果:西酞普兰治疗前后的自身对照表明治疗强迫症疗效显著(χ2=135.02,P<0.01)。西酞普兰与氯米帕明在治疗2周和治疗结束时的组间疗效比较,分别为d=-0.83,95%CI(-1.34,-0.31),χ2=9.99,P<0.01;y合并=-0.08,95%CI(-0.27,0.10),综合显著性检验差异无显著性(χ2=0.81,P>0.05)。提示西酞普兰起效较快,两组疗效相仿。西酞普兰的不良反应显著少于氯米帕明。结论:西酞普兰治疗强迫症疗效与氯米帕明相仿,但起效快,不良反应少。

Objective： To study the difference of efficacy and side effect of citalopram and clomipramine in the treatment of obsessive-compulsive disorder （OCD）. Method ：A total of 9 comparative studies of citalopram and clomipramine in the treatment of OCD were analyzed by meta-analysis. Results：Obsessive-compul- sive symptoms improved significantly with citalopram treatment（ X2 = 135.02, P 〈 0. 01 ）. Comparison between citalopram and elomipramine at 2nd weekend after treatment and at the end of trials showed that d = - 0.83, 95%CI（ -1.34, -0.31）,X2 =9.99,P 〈0.01 ;yco = -0.08,95% CI （ -0.27,0. 10）,~2 =0.81,P 〉0.05. This revealed that there was no significant difference between eitalopram and clomipramine with respect to the clinical efficacy. However, eitalopram bad a rapid effect on symptoms, with significantly less adverse effects compared with elomipramine. Conclusion：Citalopram has a similar clinical efficacy compared with elomipramine ,with rapid treatment effect and less adverse effects.