喹硫平与利培酮治疗成人精神分裂症疗效及安全性的Meta分析

The Efficacy and Safety of Quetiapine and Risperidone for Schizophrenia:A Meta-Analysis

目的系统评价喹硫平与利培酮治疗成人精神分裂症的疗效及安全性。方法检索PubMed、Cochrane Library、EBSCO、CNKI、SinoMed、VIP和WANFANG DATA等（时间均从建库到2014年11月）,纳入喹硫平与利培酮对治疗成人精神分裂症的随机对照试验（RCT）进行比较,对文献进行质量评价,根据评价纳入研究,采用RM 5.3软件进行分析。结果共纳入6个RCT,包括2 107例精神分裂症患者。Meta分析结果显示：1）喹硫平组因缺乏疗效的终止治疗率较利培酮组高[RR=1.31,95%CI（1.10~1.55）,P=0.002];2）喹硫平组因无法耐受的终止治疗率与利培酮组相当[RR=1.18,95%CI（0.90~1.53）,P=0.23];3）不良反应发生率不一,喹硫平组嗜睡较多[RR=1.29,95%CI（1.11~1.50）,P=0.000 9];利培酮组失眠较多[RR=0.75,95%CI（0.62~0.91）,P=0.004];两组性功能紊乱比较差异无统计学意义[RR=0.73,95%CI（0.50~1.06）,P=0.09];两组锥体外系反应比较差异无统计学意义[RR=0.56,95%CI（0.25~1.29）,P=0.18];4）血糖、甘油三酯和催乳素等资料异质性太大,未做Meta分析。结论喹硫平疗效不及利培酮,而安全性与其相当。

Objective To assess the effectiveness and safety of quetiapine and risperidone in the treatment of schizophrenia. Methods We searched PubMed, Cochrane Library, EBSCO, CNKI, SinoMed, VIP and WANFANG DATA （from inception to November 2014） to obtain randomized controlled trails （RCT） comparing quetiapine with risperidone for schizophrenia. The quality of the included trails was evaluated and meta-analysis was conducted by RevMan 5.3 software. Results Six RCT involving 2 107 patients were included. The results of meta analysis showed that the effectiveness of the quetiapine group was lower than that of the risperidone group： [RR= 1. 31,95% CI （1. 10,1.55）,P=0. 002] the safety of the two groups were similar [RR= 1.18,95%CI （0.90,1.53）,P-0. 231. Adverse events., the incidence of somnolence in the quetiapine group was higher than the risperidone group [RR = 1.29,95%CI （1. 11,1. 50）,P=0. 000 9],the incidence of insomnia in the quetiapine group was lower than the risperidone group [RR=0. 75,95%CI （0.62,0.91） ,P=0. 004],the incidences of sexual imbalance in the two group were Similar[RR=0.73,95%CI （0.50,1.06） ,P=0. 092,the incidences of extrapyramidal effects in the two group were similar [RR=0.56,95%CI （0.25,1.99） ,P=0. 18]. Other outcomes could not be analyzed,because there was significant heterogeneity. Conclusion The efficiency of quetiapine is less effective than risperidone, however, both of them have the same safety.