药物、心理、物理和其他治疗对轻中度抑郁症患者的疗效比较:一项随机对照试验的Meta分析

Comparison of drug,psychological,physical and other treatments in patients with mild to moderate depression:a meta-analysis of a randomized controlled trial

目的:比较药物、心理、物理和其他治疗对轻中度抑郁症患者的疗效。方法:收集2000年1月至2019年6月间国内外数据库有关轻中度抑郁症患者治疗方法的随机对照研究(RCT),分析药物治疗、心理治疗、物理治疗与其他治疗(单一治疗组)与其联合治疗(联合治疗组)的疗效。结果:共筛选文献31篇,共有被试4294例。Meta分析结果显示,单一治疗组与对照组间疗效差异有统计学意义(P<0.01);联合治疗组与对照组间疗效差异无统计学意义(P>0.05)。药物治疗组、心理治疗组、心理和其他联合治疗组与对照组间的疗效差异有统计学意义(P均<0.01);而物理治疗组、其他治疗组、药物和心理联合治疗组以及药物和其他联合治疗组与对照组间疗效差异无统计学意义(P均>0.05)。结论:在单一治疗组中,药物治疗的疗效最好,其次为心理、其他和物理治疗。在联合治疗组中,药物加其他治疗的疗效最好,其次是药物加心理治疗、心理加其他治疗。

Objective:Compare the efficacy of drug,psychological,physical and other treatments in patients with mild to moderate depression.Method:Randomized controlled studies(RCT)in the treatment of patients with mild to moderate depression were collected from domestic and foreign databases from January 2000 to June 2019.The efficacy of drug,psychological,physical and other treatments(single treatment groups)and their combination treatments(combination treatment groups)was analyzed.Results:A total of 31 literatures were screened,with a total of 4294 subjects.The results of meta-analysis showed that the difference in efficacy between the monotherapy group and the control group was statistically significant(P<0.01).There was no statistically significant difference between the combined treatment group and the control group(P>0.05).The efficacies between the drug treatment group,the psychotherapy group,the psychological and other combination treatment group and the control group were statistically significant different(all P<0.01).However,there were no statistically significant differences between the physiotherapy group,the other treatment group,the drug and psychological combination treatment group,the drug and other combination treatment group and the control group(all P>0.05).Conclusion:In the monotherapy group,drug therapy is the most effective,followed by psychological,other and physical therapy.In the combined treatment group,drug combined with other treatment has the best effect,followed by drug and psychological treatment,psychological and other treatment.