度洛西汀与艾司西酞普兰治疗抑郁症疗效与安全性的系统评价

Efficacy and safety of duloxetine and escitalopram for the treatment of depression

目的系统评价度洛西汀与艾司西酞普兰治疗抑郁症的有效性及安全性。方法系统检索CNKI、VIP、CBM、Medline、Pubmed、Embase数据库,检索公开发表的度洛西汀与艾司西酞普兰治疗抑郁症的随机对照研究(RCT),对符合纳入标准的文献用RevMan 5.0软件对文献数据进行Meta分析。结果共纳入9个RCT,共计1528例抑郁症患者。Meta分析结果显示:治疗6,8周后2组的有效率、治愈率及汉密尔顿抑郁量表(HAMD)评分的差异均无统计学意义。艾司西酞普兰组口干、便秘、失眠、恶心、呕吐、食欲减退方面发生率明显低于度洛西汀组(P<0.05);其余不良反应差异无统计学意义。结论度洛西汀与艾司西酞普兰都能有效治疗抑郁症且疗效相当,但艾司西酞普兰安全性优于度洛西汀。

Objective To systematically assess the efficacy and safety of duloxetine and escitalopram for depression. Methods Searched CNKI, VIP,CBM,Medline,Pubmed,Embase database by computer,and researched published randomized controlled trials（ RCTs） focused on duloxetine vs. escitalopram in the treatment of depression. Metaanalysis was conducted by RevMan 5. 0 software. Results A total of 9 RCTs were included,involving 1528 depression patients. The results of Metaanalysis revealed that： there was no significant difference of the efficacy, full remission rate,the HAMD scores between two groups after 6 weeks and 8 weeks treatment. Adverse reactions： the incidence rate of dry mouth,constipationin,insomnia,nausea,vomiting,dcreased appetite in escitalopram group were significantly lower than that of duloxetine group（ P 0. 05）. There were no significant difference in other adverse reactions（ P 0. 05）. Conclusion Duloxetine and escitalopram are equally effective in the treatment of depression but escitalopram is safer.