雌激素联合抗抑郁药物治疗我国围绝经期妇女抑郁效果评价的Meta分析

Meta-analysis on effect evaluation of estrogen combined with antidepressants in treating perimenopause-related depression in our country

目的系统评价雌激素联合抗抑郁药物治疗我国围绝经期妇女抑郁症状的临床疗效。方法计算机检索中国生物医学文献光盘数据库(CBMdisc)、中国知网(CNKI)、万方数据知识服务平台、PubMed、Cochrane Library和Google学术等电子数据库,设置主题词检索1980年1月至2016年2月国内外发表的关于雌激素联合抗抑郁药物治疗我国围绝经期妇女抑郁的临床效果评价的相关文献。应用RevMan5.1软件对纳入文献的研究数据及结果进行Meta分析。结果共纳入15篇符合纳入标准的文献。数据合并结果显示,与单独使用雌激素治疗组相比,雌激素联合抗抑郁药物治疗组在有效率(RR=1.46,95%CI=1.29~1.66,P<0.01)、HAMD评分(WMD=-4.61,95%CI=-5.63^-3.59,P<0.01)和KMI评分(WMD=-5.83,95%CI=-11.12^-0.53,P<0.01)3个方面差异有统计学意义。结论雌激素替代治疗联合抗抑郁药物对临床围绝经期症状及抑郁症状的治疗及缓解效果显著优于单独使用雌激素替代治疗。

Objective To systematically assess the clinical efficacy of estrogen combined with antidepressants in the treatment of perimenopause-related depression in our country by meta analysis.Methods The electronic databases of CBMdisc,CNKI,VIP,Wanfang,PubMed,Cochrane Library and Google Scholar were retrieved by computer.The subject terms were set for retrieving the literatures on the effect evaluation of estrogen combined with antidepressants in treating perimenopause-related depression in our country published at home and abroad from January 1980 to February 2016.The study data and results of included literatures were performed the meta analysis by using the RevMan 5.1software.Results Fifteen articles conforming to the inclusion standard were included.The data merged results showed that compared with single estrogen use group,in the aspects of the effective rate（RR=1.46,95%CI=1.29-1.66,P〈0.004）,HAMD score（WMD=-4.61,95% CI=-5.63--3.59,P〈0.01）and KMI score（WMD=-5.83,95%CI=-11.12--0.53,P〈0.01）,the estrogen combined with antidepressants group had statistically significant difference.Conclusion The treatment and alleviating effect of estrogen substitution therapy combined with antidepressants for treating perimenopause symptoms and depression is superior to that of single estrogen use substitution therapy.