氨磺必利对比阿立哌唑治疗阴性精神分裂症的效果和安全性Meta分析

Meta-analysis of the Efficacy and Safety of Amisulpride Versus Aripiprazole in the Treatment of Negative Schizophrenia

目的系统评价氨磺必利对比阿立哌唑在阴性精神分裂症中的治疗效果和安全性,为临床精神分裂症的治疗和合理用药提供参考。方法检索PubMed、EMBASE、Cochrane Library、中国知网、万方和维普数据库中关于氨磺必利和阿立哌唑治疗阴性精神分裂症的效果和安全性的随机对照研究(RCTs)。根据纳入与排除标准对检索到的文献进行筛查、资料提取和数据核对,并使用RevMan5.3软件进行数据Meta分析。结果共纳入16个RCTs涉及1222例阴性精神病患者。Meta分析结果表示氨磺必利和阿立哌唑治疗阴性精神分裂症的PANSS评分≥30%、PANSS评分≥50%、SANS评分≥25%的临床有效率差异无统计学意义(均P>0.05)。治疗后4周和8周的PANSS评分差值差异有统计学意义(均P<0.05),而2周时的PANSS评分差值差异无统计学意义(P=0.55)。治疗后2周、4周和8周的SANS评分差值均差异无统计学意义(均P>0.05)。治疗后口干、震颤、月经紊乱和体重增加的发生率差异有统计学意义(均P>0.05),而在嗜睡、失眠、便秘和视物模糊上均差异无统计学意义(均P>0.05)。结论氨磺必利对比阿立哌唑在阴性精神分裂症中的治疗效果相当,药物相关不良反应有所差异。尚需大样本高质量的RCTs进一步验证氨磺必利对比阿立哌唑在阴性精神分裂症中的治疗效果和安全性。

Objective To systematically evaluate the therapeutic effect and safety of amisulpride versus aripiprazole in negative schizophrenia,and to provide a reference for the treatment of clinical schizophrenia and rational drug use.Methods Randomized controlled studies(RCTs)on the effect and safety of amisulpride and aripiprazole for negative schizophrenia were searched in PubMed,EMBASE,Cochrane Library,CNKI,Wanfang and VIP databases.The retrieved literatures were screened,extracted and checked according to the inclusion and exclusion criteria,and data Meta-analysis was performed using RevMan5.3 software.Results A total of 16 RCTs involving 1222 negative psychopaths were included.The results of Meta-analysis showed that there was no statistical significance in clinical response rates of PANSS score≥30%,PANSS score≥50%and SANS score≥25%between amisulpride and aripiprazole in the treatment of negative schizophrenia(all P>0.05).The difference of PANSS score at 4 and 8 weeks after treatment was statistically significant(all P<0.05),while the difference of PANSS score at 2 weeks was not statistically significant(P=0.55).There was no significant difference in SANS scores at 2,4 and 8 weeks after treatment(all P>0.05).After treatment,there were significant differences in the incidence of dry mouth,tremor,menstrual disturbance and weight gain(all P<0.05),but no significant differences in drowsiness,insomnia,constipation and blurred vision(all P>0.05).Conclusion The therapeutic effect of amisulpride was comparable to that of aripiprazole in negative schizophrenia,but there were differences in drug-related adverse reactions.A large sample of highquality RCTs is needed to further validate the efficacy and safety of amisulpride versus aripiprazole in negative schizophrenia.