艾司西酞普兰和文拉法辛治疗抑郁症的有效性及安全性的Meta分析

Meta-analysis on effectiveness and safety of escitalopram and venlafaxine in treatment of depression

目的:利用Meta分析方法系统分析艾司西酞普兰与文拉法辛治疗抑郁症的疗效及安全性,为指导其临床应用提供参考。方法:计算机检索Cochrane图书馆临床对照试验资料库(2012年第3期)、Embase数据库(1966-2012年9月)、PubMed数据库(1948-2012年9月)、Ovid-medline全文数据库(1966-2012年9月)、维普数据库(VIP)(1989-2012年9月)。中国学术文献总库(CNKI)(1979-2012年9月)及万方数字化期刊库(1981-2012年9月),按纳入与排除标准选择试验、评价试验质量,手工检索文献,提取资料,并用RevMan5.2.1软件对所提取数据进行Meta分析。结果:初步检索出共128篇相关文献,经过逐步筛选最终纳入15篇关于艾司西酞普兰与文拉法辛治疗抑郁症的随机对照研究。有效性,艾司西酞普兰与文拉法辛治疗抑郁症的总有效率比较差异无统计学意义[χ2=2.56,df=14,P=1.00,Z=1.38(P=0.17);95%CI(0.90,1.83)]。安全性,艾司西普酞兰治疗抑郁症不良反应发生率低于文拉法辛[χ2=28.19,df=14,P=0.01,Z=3.16(P=0.002);95%CI(0.50,0.85)]。结论:艾司西酞普兰与文拉法辛治疗抑郁症具有相似的疗效,但不良反应的发生率低于文拉法辛。

Objective To analyze the effectiveness and safety of escitalopram and venlafaxine in treatment of depression with Meta-analysis and to provide reference for their application in clinic.Methods Computer search was performed using the Cochrane Central Register of Controlled Trial（Issue 3,2012）,Embase（1966to 2012.09）,PubMed（1948to 2012.09）,Ovid-medline（1966to 2012.09）,VIP（1989to 2012.09）,CNKI（1979to 2012.09and WanFang（1981-2012.09）,and the randomized controlled trials（RCTs）were collected,then the retrieved studies according to predefined inclusion and exclusion criteria were screened,and the quality of included studies was evaluated and RevMan 5.2.1software was used for Meta-analysis.Results A total of 128articles were found and 15 of which were finally included.There was no significant difference of effectiveness between escitalopram and wenlafaxine in treatment of depression,χ2=2.56,df=14,P=1.00,Z=1.38（P=0.17）;95%CI（0.90,1.83）.The incidence of adverse reaction of escitalopram in treatment of depression was lower than that of venlafaxine,χ2=28.19,df =14,P =0.01,Z =3.16（P =0.002）;95% CI（0.50,0.85）.Conclusion Escitalopram has the similar effectiveness with venlafaxine in treatment of depression,but its incidence of adverse reaction is lower than estazolam.