文拉法辛与选择性五羟色胺再摄取抑制剂对抑郁症转换策略疗效的Meta分析

The efficacy of venlafaxine and selective serotonin reuptake inhibitors in antidepressant switching strategies:a meta-analysis

目的系统评价文拉法辛(venlafaxine)与选择性5-羟色胺再摄取抑制剂(selective serotoninreuptake inhibitor,SSRI)对抑郁症转换策略疗效的差异。方法检索1990～2010年的MEDLINE和中文文献,纳入文拉法辛与SSRI对抑郁症转换策略治疗效果的随机对照试验并进行Meta分析。结果 8个随机对照试验符合纳入标准,共5350例抑郁症患者。Meta分析结果显示,文拉法辛的临床治愈率是52.5%,SSRI的临床治愈率是43.3%,二者的差异有统计学意义(OR=1.38,95%CI:1.20～1.58,P<0.01);文拉法辛的有效率是67.8%,SSRI的有效率是59.6%,二者的差异有统计学意义(OR=1.33,95%CI:1.15～1.53,P<0.01)。结论文拉法辛较SSRI对抑郁症转换策略有更高的临床治愈率与有效率。

Objective To systematically review the difference in efficacy between venlafaxine and selective serotonin reuptake inhibitors （SSRI） in antidepressant switching strategies. Methods We conducted a meta-analysis comparing the efficacy between venlafaxine and SSRI in antidepressant switching strategies. The randomized controlled trials （RCT） were identified through searches of MEDLINE and Chinese publications for the years 1990 to 2010. Results Eight RCTs involving 5350 patients with maior depressive met inclusion criteria. Results of meta-analysis showed that the remission rates were 52.5% and 43.3% for venlafaxine and SSRI, respectively. There were statistically significant difference （OR = 1.38, 95%CI： 1.20 - 1.58, P 〈 0.01） in remission rates between the two treatment groups. The response rates were 67.8% and 59.6% for venlafaxine and SSRI, respectively. There were statistically significant difference （OR = 1.33, 95%CI： 1.15 - 1.53, P 〈 0.01） in response rates between the two treatment groups. Conclusions Remission and response rates are significantly higher in venlafaxine than in SSRI in antidepressant switching strategies.