阿立哌唑与氯氮平治疗难治性精神分裂症对照研究的Meta分析

A meta-analysis on comparison between aripiprazole and clozapine in the treatment of treatment resistant schizophrenia

目的对比分析阿立哌唑与氯氮平治疗难治性精神分裂症(TRS)的疗效和不良反应。方法应用国际Cochrane协作网系统评价方法评价阿立哌唑与氯氮平治疗TRS的临床随机对照试验(RCT)。计算机检索Pubmed、Cochrane临床对照试验资料库、CNKI、万方数据库、维普数据库,检索的起止时间为建库至2017年8月31日。纳入阿立哌唑与氯氮平治疗TRS的RCT文献10篇,由2名评价者独立提取资料并进行质量评估。RCT数据的Meta分析采用Excel软件和Cochrane协作网提供的Rev Man 5.3软件。结果阿立哌唑与氯氮平治疗TRS的疗效比较差异无统计学意义[OR 1.05,95%CI(0.76,1.44),P>0.05];但阿立哌唑引起的不良反应显著少于氯氮平(P<0.05或P<0.01)。结论现有临床证据表明,阿立哌唑治疗TRS的疗效与氯氮平相仿,但阿立哌唑不良反应少。

Objective To explore the differences of efficacy and safety between aripiprazole and clozapine in the treatment of treatment resistant schizophrenia(TRS）. Methods To retrieved the Pub Med,Cochrane Library,CNKI,Wanfang database and Vip database from the establishment of the database to August 31 st 2017. Ten RCTs containing aripiprazole and clozapine for treatment of refractory schizophrenia were included,screened by inclusion and exclusion criteria. The screened literatures were evaluated and Meta analyzed by Revman 5. 3 software. Results A total of 106 relevant documents were retrieved,10 RCTs selected for Meta-analysis. The results of the Meta-analysis showed there was no significant difference of the efficacy between aripiprazole and clozapine in the treatment of TRS [OR 1. 05,95% CI(0. 76,1. 44）,P〉0. 05]. Adverse reactions were slighter in aripiprazole group than in clozapine group(P〈0. 05 or P〈0. 01）. Conclusion Therapeutic effects of aripiprazole and clozapine for TRS are similar,but aripiprazole shows fewer adverse reactions.