奥氮平联合氟西汀治疗抑郁症的系统评价

Systematic Review of Olanzapine Combined with Fluoxetine in the Treatment of Depression

目的:系统评价奥氮平联合氟西汀治疗抑郁症的疗效与安全性。方法:计算机检索中国期刊全文数据库、维普中文科技期刊数据库以及中国学位论文全文数据库关于奥氮平联合氟西汀与氟西汀对照治疗抑郁症的文献,应用系统评价方法对查阅到的文献进行Meta分析。结果:共纳入8项研究,合计512例患者。奥氮平联合氟西汀与单用氟西汀比较,总有效率较高[χ2=2.77,P<0.00001,OR=2.82,95%CI(1.82,4.37)],从第4天至治疗结束,汉密顿抑郁量表(HAMD)评分显著减少(P<0.01),同时不良反应发生率也较高[χ2=8.59,P<0.05,OR=1.61,95%C(I1.10,2.34)],但不良反应均较轻微,患者可以耐受。结论:奥氮平联合氟西汀较单用氟西汀治疗抑郁症的疗效好,起效快,不良反应可耐受。

To study the difference in therapeutic effects and adverse drug reactions of olanzapine combined with fluoxetine vs. fluoxetine for depression. METHODS： RCTs on olanzapine combined with fluoxetine and fluoxetine in the treatment of depression were retrieved from CNKI, VIP and ETD full text databases. System evaluation was adopted to evaluate included literatures. RESULTS： 8 RCTs were included, involving 512 patients. Compared with fluoxetine, olanzapine combined with fluoxetine had higher effective rate [X^2=2.77,P〈0.000 01, OR=2.82,95% CI （1.82,4.37）], lower HAMD score from 4th day to the end of treatment （P〈0.01） and higher adverse drug reaction rate [X^2=8.59,P〈0.05, OR= 1.61,95% Cl（1.10,2.34）]. But the adverse drug reactions were slight and well tolerated. CONCULSION： Olanzapine combined with fluoxetine is of good efficacy and rapid onset and the adverse drug reactions are well tolerated.