阿立哌唑治疗儿童Tourette综合征的疗效及安全性Meta分析

Efficiency and safety of Aripiprazole in the treatment of children with Tourette＇s syndrome：a Meta -analysis

目的比较阿立哌唑与其他传统药物治疗儿童Tourette综合征的疗效和安全性。方法检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、WebofScience数据库中与阿立哌唑治疗儿童Tourette综合征有关的文献，检索时限均为建库至2015年9月。由2位研究人员按纳入和排除标准筛选文献，提取数据，对纳入文献进行质量评价，综合评价阿立哌唑的治疗效果和安全性。数据分析采用Stata11．0软件进行。结果共纳入4篇文献进行Meta分析，包括396例患儿（阿立哌唑组201例，对照组195例）。阿立哌唑疗效与对照组（安慰剂、硫必利及氟哌啶醇）治疗Tourette综合征的疗效差异有统计学意义[标准化均数差（SMD）=0．21，95％CI：0．10—0．32]。不同治疗时间疗效的亚组分析结果显示：2周时2组治疗效果差异具有统计学意义（SMD=0．28，95％CI：0．06～0．50）；4周及8周时阿立哌唑组与对照组的疗效差异没有统计学意义（SMD=0．16、0．28；95％CI：一0．05—0．38、一0．20—0．76）。不同对照组治疗药物的亚组分析结果显示：阿立哌唑组的疗效优于硫必利组，差异具有统计学意义（SMD=0．29，95％CI：O．15～0．43）；阿立哌唑与氟哌啶醇的治疗效果差异没有统计学意义（SMD：一0．03，95％CI：一0．28～0．22）。阿立哌唑组的不良反应发生率与对照组比较差异无统计学意义（RR=0．83，95％CI：0．36—1．89）。结论与传统药物相比，阿立哌唑在治疗Tourette综合征2周时效果较好，阿立哌唑的效果优于硫必利，与氟哌啶醇治疗效果相当，不良反应率与其他药物无差异，安全性有待进一步考证。

Objective To compare the efficiency and safety between Aripiprazole and other traditional drugs for Tourette＇s syndrome treatment. Methods Databases such as China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine Disc, PubMed and Web of Science were electronically searched for studies on Aripiprazole for Tourette＇s syndrome treatment. According to the inclusion and exclusion criteria, studies, extracted data, and as- sessed quality were screened. Meta - analysis was performed by using Stata 11.0 software. Results Four studies about Aripiprazole for Tourette＇s syndrome treatment with 396 patients （Aripiprazole group ：201 cases; control group：195 ca- ses） were synthetically and quantitatively analyzed. Meta- analysis results showed that Aripiprazole was better than other traditional agents （ placebo, Tiapride, Haloperidol ） [ standardized mean difference （ SMD ） = 0.21,95% CI： 0. 10 -0. 32 ]. The subgroup by time of treatment analysis results indicated that Aripiprazole was superior to other drugs in 2 weeks （SMD =0.28,95% C1：0.06-0.50）. There was no significant difference in the efficacy between Aripi- prazole and other drugs for treatment of Tourette＇s syndrome in 4 weeks and 8 weeks after treatment （SMD = 0. 16, 0.28 ;95% CI： - 0. 05 - 0.38, - 0.20 - 0. 76）. The subgroup by matched drugs results suggested that Aripiprazole was better than Tiapride （SMD = 0.29,95 % CI：0. 15 -0.43 ）, but was not significantly different from Haloperidol （SMD = -0.03,95% CI： -0. 28 -0.22）. There was no significant difference in side effects incidence between Aripiprazole and traditional drugs for treatment of Tourette＇s syndrome （RR = 0.83,95% CI：0. 36 - 1.89）. Conclusions Com- pared with the conventional drugs, Aripiprazole has better therapeutic efficacy in the treatment of Tourette＇s syndrome in children in 2 weeks. Aripiprazole is better than Tiapride, but equal to Haloperidol in the treatment of Tourette＇s syn- drome. The safety of Aripiprazole needs to be further verified.