舍曲林治疗卒中后抑郁的Meta分析

Meta analysis of sertraline treatment on post stroke depression

目的系统分析舍曲林治疗卒中后抑郁(PSD)的疗效。方法检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM),查找以舍曲林治疗PSD的随机对照试验(RCT),对纳入的RCT进行质量评价,采用Rev Man 5.1软件进行Meta分析。结果共纳入9项RCT,包括791例PSD患者。Meta分析结果显示,治疗4周、8周及12周后,试验组汉密尔顿抑郁量表(HAMD)评分下降程度明显高于对照组(MD=-3.04、-6.64、-6.27,95%CI:-3.78^-2.30、-7.67^-5.61、-11.08^-1.46);治疗4周、8周后美国国立卫生院神经功能缺损评分(NIHSS)改善程度明显高于对照组(MD=-2.07、-2.38,95%CI:-2.62^-1.53、-3.38^-1.38);治疗4周、8周及12周后BI指数升高程度高于对照组(MD=6.18、12.92、12.76,95%CI:2.72~9.65、8.00~17.84、4.54~20.97)。结论舍曲林可明显改善PSD患者的抑郁症状,并且有益于改善其日常生活能力,促进患者神经功能的恢复。

Objective Systematic review the effect of sertraline on post stroke depression （PSD）. Methods Searching the database within Cochrane Library, Medline, Embase, Chinese Biomedical Literature Database （CBM）, and focused on the topic on sertraline PSD randomized controlled trials （RCT） ,meanwhile to assess the quality of RCT quality by Rev Man 5.1 software. Results A total of nine RCT enrolled,including 791 cases of patients with PSD. Meta analysis results suggest that HAMD score after 4 weeks, 8 weeks and 12 weeks, in sertraline group was significantly decreased than control group（4th weeks： MD=-3.04, 95% CI=-3. 78, -2.30;8th：MD= - 6.64,95%CI= - 7.67, - 5. 61; 12th：MD= - 6.27,95% CI= - 11.08, - 1.46） ;while NIHSS score,BI index of the degree of improvement was significantly better in treatment group than control, NIHSS score, （4th weeks：MD=-2.07,95%CI=-2.62,1.53;12th：MD=-2.38,95%CI=-3.38,-1.38;BI Index, 4th weeks：MD= 6.18,95% CI=2.72, 9.65;8th：MD=12.92,95%CI=8.00, 7.84;12th：MD=12.76,95%CI=4.54,20.97）.Conclusion Sertraline can significantly control the symptoms of depression in patients with PSD,while it can help to improve the patient＇s activities of daily living and to promote the recovery of neurological function.