帕罗西汀治疗躯体形式障碍的系统评价

Systematic Review of Paroxetine in the Treatment of Somatization Disorder

目的:探讨帕罗西汀治疗躯体形式障碍的疗效和不良反应。方法:采用Meta分析对13项帕罗西汀和其他抗抑郁药物治疗躯体形式障碍对照研究的文献进行分析。结果:本研究共纳入13篇文献,包括723例患者,进行了四项亚组分析。治疗2周后,帕罗西汀组的躯体形式障碍症状改善程度显著高于对照组[MD=-2.10,95%CI(-3.52,-0.67),P=0.004]。治疗4周后,帕罗西汀组的躯体形式障碍症状改善程度显著高于对照组[MD=-1.36,95%CI(-2.38,-0.33),P=0.009]。治疗6周后,两组对躯体形式障碍症状改善程度的差异无显著性[MD=-0.76,95%CI(-1.87,-0.35),P=0.18],治疗8周后,两组对躯体形式障碍症状改善程度的差异无显著性[MD=-0.50,95%CI(-1.32,-0.32),P=0.23]。两组治疗躯体形式障碍的不良反应的差异无显著性[MD=-1.35,95%CI(-6.77,-4.08),P=0.63]。结论:帕罗西汀与对照组相比较,疗效和不良反应差异均无显著性,但帕罗西汀起效较快,能更早地改善患者的躯体形式障碍症状。

Objective：To study the efficacy and side effect of Paroxetine in the treatment of somatization disorder.Methods：13 com-parative studies of Paroxetine and other antidepressants in the treatment of somatization disorder were analyzed by meta -ananlysis.Re-sults：We included 13 studies with 723 patients.Four treatment period subgroups were created：2, 4, 6 and 8 weeks.In the 2-week sub-group, paroxetine was more efficacious than controlled group [MD=-2.10,95%CI（-3.52,-0.67）,P=0.004].In the 4-week sub-group, paroxetine was more efficacious than controlled group [MD=-1.36,95%CI（-2.38,-0.33）,P=0.009].In the 6-week sub-group, two drugs displayed comparative efficacy [ MD=-0.76 ,95%CI （ -1.87 ,-0.35 ） , P=0.18 ].In the 8-week subgroup , two drugs displayed comparative efficacy [MD=-0.50,95%CI（ -1.32,-0.32）,P=0.23].There were no significant differences in safety [ MD=-1.35 ,95%CI （ -6.77 ,-4.08 ].Conclusion： Paroxetine had a similar treatment effect and side effect to other con-trolled antidepressants.But Paroxetine had a earlier effect.It can improve the symptoms of somatoform disorder patients earlier.