抗焦虑或抗抑郁药辅助治疗功能性消化不良疗效的Meta分析

Efficiency of antianxiety agents or antidepressants in the treatment of functional dyspepsia:a Meta-analysis

目的系统评价抗焦虑或抗抑郁药辅助治疗功能性消化不良(FD)的疗效。方法计算机检索PubMed、EMBASE、Wed of Science、The Cochrane library、CNKI全文数据库、万方数据库以及中国科技期刊数据库,检索时间建库至2015年12月,搜集关于抗焦虑或抗抑郁药治疗FD的随机对照试验(R/CT),采用Stata12.0对纳入的研究进行Meta分析。结果共8项RCT包含886例患者符合入选标准。Meta分析结果显示:与安慰剂相比,抗焦虑或抗抑郁药能够降低消化不良症状总分,差异有统计学意义(SMD=-0.32,95%CI-0.636^-0.004,P=0.047);亚组分析显示,抗焦虑药对FD的治疗效果优于安慰剂(SMD=-0.47,95%CI-0.931^-0.016,P=0.043),而抗抑郁药的疗效与安慰剂相比差异无统计学意义(SMD=-0.23,95%CI-0.646~0.182,P=0.271)。在不良反应方面,抗焦虑或抗抑郁药不良反应发生率较低,与安慰剂相似(OR=1.25,95%CI 0.847~1.847,P=0.261)。结论抗焦虑药可能是治疗FD的有效药物,且较为安全,但抗抑郁药对FD的治疗作用有待进一步的探讨。

Objective To evaluate the efficacy of antianxiety agents or antidepressants in the treatment of functional dyspepsia （ FD） .Methods Articles regarding the efficacy and safety of antianxiety agents or antidepressants were retrieved from PubMed, EMBASE, Web of Science, The Cochrane library, Chinese Journals Full text Database （ CNKI, China National Knowledge Infrastructure ） , Wan Fang Digital Journal Full text Database, and Database for Chinese Technical Periodical （VIP） to collect clinical randomized controlled trial （RCT） for FD treatment.Meta-analysis was performed by using Stata 12.0.Results A total of eight RCTs including 886 patients met the inclusion criteria.Meta-analysis results were as follows. Antianxiety agents or antidepressants were associated with a significant reduction in dyspepsia symptoms score compared with placebo therapy（SMD=-0.32,95%CI -0.636 to -0.004, P =0.047）.Subgroup analysis indicated that the treatment effect of antianxiety agents for FD was superior to placebo（SMD=-0.47,95%CI -0.931 to -0.016, P =0.043）,but an-tidepressants had no statistical difference compared with placebo（SMD=-0.23,95%CI -0.646 to 0.182, P =0.271）.In terms of adverse reactions, antianxiety agents or antidepressants has low incidence of adverse reactions, being similar to place-bo（OR=1.25,95%CI 0.847 to 1.847, P =0.261）.Conclusion Antianxiety agents may be effective and safe for FD treatment, but the role of antidepressants needs future study.