度洛西汀与帕罗西汀治疗成人伴有疼痛症状的抑郁障碍临床疗效的Meta分析

Clinical efficacy of duloxetine versus paroxetine for adults＇ depression with pain： a Meta-analysis

目的 系统评价度洛西汀与帕罗西汀治疗成人伴有疼痛症状抑郁障碍的临床疗效比较.方法 计算机检索Cochrane Library（2014年第6期）,PubMed、EBSCO、Ovid、sinimed、VIP、WanFang Data（检索年限均为1998～2014年6月）,纳入度洛西汀与帕罗西汀比较治疗成人伴有疼痛症状抑郁障碍的RCT研究,按照Cochrane Reviewer＇s Handbook 5.2系统标准评价纳入研究的质量后,采用Rev-Man 5.2软件进行Meta分析.结果 共纳入8个RCT研究,合计1 226例抑郁症患者.Meta分析结果显示：治疗8周后,度洛西汀组HAMD评分较帕罗西汀组低,两组间比较差异有统计学意义（95％CI=-0.25～-0.17,P＜0.01）;度洛西汀组各种疼痛评价工具的评分较帕罗西汀组低,且差异有统计学意义（95％CI=-1.06～-0.42,P＜0.01）.结论 度洛西汀治疗成人伴有疼痛症状的抑郁障碍的疗效较帕罗西汀好.

Objective To systematically evaluate the clinical efficacy of duloxetine versus paroxetine for adults＇ depression with pain. Methods A search was conducted in the Cochrane Library （Issue 6, 2014）, PubMed （1998 to June 2014）, EBSCO（1998 to June 2014）, Ovid（1998 to June 2014）, sin-imed（1998 to June 2014）, VIP（1998 to June 2014）, WanFang Data（1998 to June 2014）. The randomized controlled trials （RCTs） on duloxetine versus paroxetine for adults＇ depression with pain were col- lected. The quality of the included trials was assessed according to the Cochrane Reviewer＇s Handbook 5.2, and the systematic analysis was conducted by using RevMan 5.2 software. Results Eight RCTs in- volving 1 226 patients were included. The results of Meta analysis showed that： after eight--week treatment, there were significant differences in the H AMD Scale （95 % CI ： -0. 25- -0. 17, P 0.01） and the Pain Scale （95% CI =-1.06-0.42, P（0.01） between the duloxetine and paroxetine groups. Conclusions The clinical efficacy of duloxetine was better than paroxetine in treatment of adults＇ depression with pain.