化痰类中药联合利培酮治疗精神分裂症的Meta分析

A Meta⁃analysis of phlegm⁃resolving Chinese medicine combined with risperidone for treatment of schizophrenia

目的:采用Meta分析方法,回顾性研究含化痰类中药的方剂联合利培酮在临床治疗精神分裂症的改善效果及不良反应发生的情况。方法:检索多个中英文数据库,检索时间为2000年1月1日~2020年5月1日。用Review Manager 5.3软件对纳入研究进行方法学质量评价。以阳性与阴性症状量表(positive and negative symptom scale,PANSS)为评价标准,对化痰类中药在中西医结合治疗精神分裂症的量表各项评分、临床疗效及安全性等数据进行meta分析,具体包括异质性检验、敏感性分析及"漏斗图"检验发表偏倚。结果:共纳入15项研究,共1 515例患者。与单用利培酮对照组相比,化痰类中药联合利培酮治疗组治疗精神分裂症的PANSS量表总分、阳性症状评分、阴性症状评分、一般精神病理评分均低于对照组[MD=-6.35,95%CI(-11.29,-1.40),P=0.01]、[MD=-1.42,95%CI(-2.74,-0.09),P=0.04]、[MD=-2.16,95%CI(-3.41,-0.91),P<0.01]、[MD=-3.80,95%CI(-6.37,-1.24),P<0.01],化痰类中药联合利培酮治疗组对精神分裂症的临床疗效优于对照组[OR=2.92,95%CI(1.78,4.80),P<0.01],且不良反应发生率降低[OR=0.46,95%CI(0.24,0.87),P=0.02]。结论:含化痰类中药联合利培酮较单用利培酮可有效提高精神分裂症患者的疗效,且能减少药物不良反应的发生。

Objective:The efficacy and occurrence of adverse reactions of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone in the treatment of schizophrenia were retrospectively studied by means of Meta-analysis.Methods:A variety of different Chinese and English databases were searched from January 1,2000 to May 1,2020. Review Manager 5.3 software was used to evaluate the methodological quality of the included studies. The positive and negative symptom scale(PANSS)was used as the evaluation standard to analyze the total scores,positive scores,negative scores and general psychopathological scores,clinical efficacy and safety of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone of schizophrenia. The heterogeneity test and sensitivity analysis were also carried out by Review Manager 5.3,and the potential publication bias was analyzed by "funnel plot". Results:A total of 1 515 patients were included in 15 studies. Compared with the control group of risperidone alone,the total PANSS scale score,positive symptom score,negative symptom score and general psychopathological score of the treatment group of phlegm-resolving Chinese medicine combined with risperidone were all lower than those of the control group[MD=-6.35,95%CI(-11.29,-1.40),P=0.01],[MD=-1.42,95%CI(-2.74,-0.09),P=0.04],[MD=-2.16,95%CI(-3.41,-0.91),P<0.01],and[MD=-3.80,95%CI(-6.37,-1.24),P<0.01],and the clinical efficacy of phlegm-resolving Chinese medicine combined with the risperidone treatment group on schizophrenia was better than that of the control group[OR=2.92,95%CI(1.78,4.80),P<0.01]. The incidence of adverse reactions was reduced[OR=0.46,95%CI(0.24,0.87),P=0.02]. Conclusion:The combination of prescriptions containing phlegm-resolving Chinese medicine and risperidone can effectively improve the efficacy of patients with schizophrenia and reduce the occurrence of adverse drug reactions compared with risperidone alone.