西酞普兰治疗广泛性焦虑症对照研究的Meta分析

Meta-analysis of control study on citalopram in the teatment of generalized anxiety disorder

目的探讨西酞普兰治疗广泛性焦虑症的疗效和不良反应的差异。方法应用Meta分析对6篇西酞普兰与其他抗焦虑剂治疗广泛性焦虑症对照研究的文章进行再分析，评价其合并效应量大小和综合显著性检验。结果西酞普兰治疗前后的自身对照，合并效应量Y合并=3．51，95％CI（3．10，3．93），χ2=6．87，P〉0．01；西酞普兰与对照药物在治疗第2w末和治疗后组间比较分别为Y合并=-0．04，95％CI（-0．31，0．23），χ2=0．05，P〉0．05；Y合并=-0．08，95％CI（-0．28，0．12），χ2=0．88，P〉0．05。西酞普兰组嗜睡、头晕等不良反应发生率均显著低于对照组（P〈0．05或0．01）；而失眠发生率低于对照组，口干、震颤发生率高于对照组，但差异无显著性（P〉0．05）。结论西酞普兰与对照组的疗效相当，但不良反应发生率较低，安全性高，依从性好。

Objective To explore the differences of efficacy and adverse reactions of citalopram in the treatment of generalized anxiety disorder（GAD）. Methods Six articles about the control study of eitalopram vs. other anxiolytic agents in the treatment of GAD were analyzed again using Meta-analysis, its merge effect size and comprehensive significance evaluated. Results Merge effect size of pre-and post-citalopram treatment auto-control was Ymerge=3.51,95%CI（3.10,3.93） ,χ2 =6.87,P〉0.01 ;those of group comparisons between citalopram and control drugs at the end of the 2nd week and posttreatment were respectively Ymerge=-0.04,95%CI（-0.31,0.23）,χ2 =0.05,P〉0.05;Ymerge=-0.08,95%CI（-0.28, 0.12） ,χ2=0.88,P）0.05. Incidences of such adverse reactions as lethargy and dizziness were significantly lower in the citalopram than in the control group（P〈0.05 or 0.01） ;incidence of insomnia was lower and those of dry mouth and tremor higher in the citalopram than in the control group,but differences were not significant （P〉0.05）. Concision Citalopram has the therapeutic equivalence to control group, but lower incidences of adverse reactions,higher safety and better compliance.