氟西汀治疗脑卒中后抑郁疗效的Meta分析

Efficacy of fluoxetine for post-stroke depression:A meta-analysis

目的系统评价氟西汀改善脑卒中后抑郁（PSD）患者抑郁情绪及促进缺损神经功能恢复的疗效。方法以脑卒中、抑郁及氟西汀等作为关键词在Cochrane图书馆、PubMed、维普及万方等数据库内检索所有关于氟西汀治疗PSD的随机对照试验（RCT）,时限为1990-01—2015-05提取原始数据,并对纳入研究进行质量评估,采用RevMan5.2软件进行统计分析。结果共纳入6项临床RCT研究,共472例患者。Meta分析显示,治疗结束,干预组汉密尔顿抑郁量表（HAMD）减分率显著优于对照组,差异有统计学意义（RR=2.84,95%CI 2.16-3.73,P〈0.000 1）;治疗结束,干预组卒中量表减分率优于对照组,差异有统计学意义（RR=1.61,95%CI 1.34-1.94,P〈0.000 1）。结论氟西汀不但可改善PSD患者抑郁情绪,亦可有效缓解患者神经功能缺损,促进其运动功能恢复。

Objective The systematic review was conducted for evaluating the efficacy of fluoxetine in improving poststroke depression（PSD）patients with depressed emotion and promoting the motor function recovery.Methods A search was conducted to search for randomized controlled trials（RCT）about fluoxetine,which were used for PSD patients,in Cochrane Library,PubMed,VIP and Wanfang database,from January 1990 to May 2015,according to the key words and MeSH Terms stroke,depression,fluoxetine,and so on.Extracting primary data and assess the quality of included literatures,meta-analysis was conducted by RevMan 5.2software.Results Six RCTs involving 472 patients were included.The results of meta-analyses showed that：at the end of treatment,reducing rate of HAMD scores in intervention group were significantly better than that in control group,the difference was significant（RR=2.84,95% CI2.16-3.73,P〈0.000 1）;at the end of the treatment,reducing rate of stroke scale scores in intervention group were significantly better than that in control group,the difference between the two groups was significant（RR=1.61,95% CI1.34-1.94,P〈0.000 1）.Conclusion Fluoxetine not only can improve depressed emotion of PSD patients,and also alleviate the deficient neurologic function,promote the recovery of motor function.