抗癫痫药及碳酸锂治疗双相躁狂有效率的评估:国内文献网状Meta分析

Evaluation of effectiveness of antiepileptic drugs and lithium carbonate in the treatment of bipolar mania:network Meta-analysis of Chinese literature

目的:运用网状Meta分析方法评价抗癫痫药及碳酸锂治疗双相躁狂的临床疗效。方法:计算机检索知网、万方、维普等国内数据库中抗癫痫药及碳酸锂治疗双相躁狂的随机对照试验(RCT),检索时间为自建库至2021年12月31日。依据Cochrane偏倚风险评估对纳入文献进行治疗评价,使用RevMan5.4及R软件的gemtc包进行数据分析。结果:最终纳入129项研究,包含14种干预措施,总样本量为17 775例。网状Meta分析结果显示,在有效率方面,排名前三的药物分别为丙戊酸盐+托吡酯、拉莫三嗪+非典型抗精神病药以及奥卡西平+非典型抗精神病药。结论:抗癫痫药联合非典型抗精神病药可提高双相躁狂的临床疗效,其中丙戊酸盐联合托吡酯在所有药物疗效指标中排名最前,具有良好的临床应用价值。

Objective:To evaluate the clinical efficacy of antiepileptic drugs and lithium carbonate in the treatment of bipolar mania by network Meta-analysis.Method:Randomized controlled trials(RCT) of antiepileptic drugs and lithium carbonate in the treatment of bipolar mania were searched from CNKI,Wanfang,CQVIP and other databases,and the literature was from self-built database to December 31,2021.The quality of the included literatures were evaluated according to the Cochrane bias risk assessment,Revman5.4 and the gemtc package of R software was used for analysis.Results:One hundred and twenty-nine studies were included,including 14 kinds of interventions,with a sample size of 17 775 cases.The results of network Meta-analysis showed that in terms of effective rate,the top three drugs combinations were valproates+ topirmanate>lamotrigine+atypical antipsychotics>oxcarbazepine+atypical antipsychotics.Conclusion:Antiepileptic drugs combined with atypical antipsychotic drugs can improve the clinical efficacy of bipolar mania,and valproates + topirmanate rank first with good clinical application value in all the drug efficacy indicators.