抗抑郁药物治疗躯体形式障碍的疗效及可接受性的网状Meta分析

Comparative efficacy and acceptability of antidepressants for somatoform disorders:A network meta-analysis

目的:评价抗抑郁药物治疗躯体形式障碍的临床疗效及可接受性。方法:电子检索中国生物医学文献数据库、中国知网、Pubmend、EMBASE.com、Cochrane Library等中英文数据库。纳入抗抑郁药治疗躯体形式障碍的随机对照试验。依据Cochrane 5.1版质量评价标准评价纳入文献的质量并进行偏倚评价,采用Stata 14.2软件进行网状Meta分析。结果:共42个研究进入了网状Meta分析,共包括15种抗抑郁药及安慰剂。结果分析显示:临床疗效前3位的是度洛西汀、阿戈美拉汀、艾司西酞普兰,如度洛西汀与舍曲林比较[OR=1.17(1.01,1.36)];可接受性前3位的是西酞普兰、氟伏沙明、米氮平。结论:药物治疗方面,兼顾有效性、可接受性、经济性等,可选择度洛西汀、阿戈美拉汀、艾司西酞普兰为一线用药。

Objective:To evaluated the efficacy and acceptability of antidepressants for the treatment of somatoform disorders.Methods:We searched Pubmend,EMBASE.com,Cochrane Library,CBM,CNKI in both English and Chinese,for the randomized controlled trial of antidepressants for somatoform disorders.Quality assessment and bias evaluation were conducted with the Cochrane Collaboration's RevMan 5.1 software.The network meta-analysis was conducted with the Stata 14.2 software.Results:A total of 42 trials met the inclusion criteria,involved 15 antidepressants and placebo.Results showed that the more effective drugs were duloxetine,agomelatine,escitalopram,as duloxetine versus sertraline[O r=1.17(1.01,1.36)].Citalopram was well tolerated,followed by fluvoxamine and mirtazapine.Conclusion:In consideration of the efficacy,acceptability and economy,duloxetine,agomelatine and escitalopram can be the first-line treatment drugs for somatoform disorders.