拉莫三嗪治疗双相障碍随机对照试验国内文献Meta分析

A meta-analysis of domestic studies on randomized controlled trials of lamotrigine for bipolar disorder

目的评价拉莫三嗪治疗双相障碍的有效性和安全性。方法全面检索国内有关拉莫三嗪治疗双相障碍的研究。疗效指标被定义为治疗后总有效率的比较。安全性被定义为研究组和对照组不良反应发生率的比较。结果单用拉莫三嗪与单用丙戊酸钠或单用碳酸锂治疗双相障碍的治疗总有效率比较差异无统计学意义(P>0.05),拉莫三嗪联合其他一种药物治疗双相情感障碍的总有效率高于单用其他药物(P<0.05)。单用拉莫三嗪治疗双相障碍的不良反应发生率低于单用丙戊酸钠(P<0.05),单用拉莫三嗪与单用碳酸锂以及拉莫三嗪联合其他一种药物与单用其他一种药物治疗双相情感障碍的不良反应发生率比较差异无统计学意义(P>0.05)。结论单用拉莫三嗪治疗双相障碍的疗效可能与单用碳酸锂或丙戊酸钠相当,不良反应发生率低于单用丙戊酸钠,联合其他药物时疗效更优,且未明显增加不良反应。

Objective To evaluate the efficacy and safety of lamotrigine in the treatment of bipolar disorder.Methods The domestic studies about lamotrigine in the treatment of bipolar disorder were selected comprehensively.Efficacy was defined as a comparison of the total response rates after treatment.Safety was defined as the comparison of incidence rates of adverse reactions between study group and control group.Results There existed no significant difference in the efficacy of treating bipolar disorder among using lamotrigine alone,valproate alone and lithium carbonate alone(P>0.05).The efficacy of lamotrigine combined with one kind of other medications in the treatment of bipolar disorder was higher than that of using one kind of other medications alone(P<0.05).The incidence rate of adverse reactions in the treatment of bipolar disorder with lamotrigine alone was significantly lower than that with valproate alone(P<0.05).There existed no significant differences in the incidence rates of adverse reactions in the treatment of bipolar disorder between using lamotrigine alone and using lithium carbonate alone,or between using lamotrigine combined with one kind of other medications and using one kind of other medications alone(P>0.05).Conclusion The efficacy of using lamotrigine alone in the treatment of bipolar disorder may be comparable to that of using lithium carbonate or sodium valproate alone,and the incidence rate of adverse reactions is lower than that of using sodium valproate alone.Lamotrigine combined with other medications showed better efficacy without significantly increased adverse reactions.