低剂量阿立哌唑增效治疗难治性抑郁症的有效性和安全性的Meta分析

Meta analysis of the efficacy and safety of low-dose aripiprazole combined with antidepressants in the treatment-resistant depression

目的:评价低剂量阿立哌唑(Aripiprazole)联合抗抑郁药物治疗难治性抑郁症(TRD)的有效性和安全性。方法:计算机检索Pub Med、Embase、Web of Science、Cochrane Library、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库、维普医药信息资源系统、中国生物医学文献数据库(CBM),收集2015年12月以前公开或未公开发表的关于低剂量阿立哌唑治疗难治性抑郁症的随机对照试验(RCTs),对纳入的研究进行资料提取和方法学质量评价后,采用Rev Man 5.2软件分析。结果:共纳入9个RCTs,1034例TRD患者,其中阿立哌唑组459例,对照组575例。Meta分析结果显示,阿立哌唑组的痊愈率明显高于对照组(RR=1.72,95%CI:1.33~2.22,P<0.01);有效率也明显高于对照组(RR=1.52,95%CI:1.25~1.83,P<0.01),差异有统计学意义;两组间不良反应发生率差异无统计学意义(RR=1.31,95%CI:0.94~1.81,P>0.05)。结论:与单纯使用抗抑郁药物相比,低剂量阿立哌唑联合抗抑郁药物治疗TRD即可具有更好的疗效。

Objective： To assess the efficacy and safety of low-dose aripiprazole combined with antidepressants in the treatment- resistant depression （TRD）. Methods： PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang database, VIP, CBM were searched to identify RCTs comparing low-dose aripiprazole with control in patients with TRD by the end of December 2015. After data extraction and methodological quality evaluation, recta-analysis was conducted with Revman 5.2 software. Results： A total of 8 RCTs were included. Among 1034 patients involved, 459 patients were in aripiprazole group while the other 575 patients were in control group. The results of Meta-analysis showed that both cure rate and effectiveness of aripiprazole group were superior to those of control group in the treatment of TRD （RR=1.72, 95% CI=1.33-2.22, P〈0.0001）, （RR=1.52, 95% CI=1.25-1.83, P〈0.0001）, respectively. The incidences of adverse events of the aripiprazole group have no significant differences compared with the control group （RR=1.31, 95% CI=0.94-1.81, P=0.11）. Conclusions： Compared with single use of antidepressants, combined use of low-dose aripiprazole with antidepressants might be effective in the treatment of TRD patients.