孙桂芝,崔明湖,都萌萌,武晓锐,张兰兰,张书懂.阿戈美拉汀治疗首发抑郁障碍效果和安全性的Meta分析[J].四川精神卫生杂志,2020,33(3):257-262.
阿戈美拉汀治疗首发抑郁障碍效果和安全性的Meta分析
Efficacy and safety of agomelatine in the treatment of first-episode depression: a Meta-analysis
投稿时间:2020-03-11  
DOI:10.11886/scjsws20200311001
中文关键词:  首发抑郁障碍  阿戈美拉汀  SSRIs/SNRIs  Meta分析
英文关键词:First-episode depression  Agomelatine  SSRIs/SNRIs  Meta-analysis
基金项目:滨州医学院科研启动基金(项目基金:首发抑郁症患者头发皮质醇激素水平的相关研究,项目编号:BY2016KJ24)
作者单位邮编
孙桂芝 滨州医学院附属医院山东 滨州 256600 256600
崔明湖 滨州医学院附属医院山东 滨州 256600 256600
都萌萌 滨州医学院附属医院山东 滨州 256600 256600
武晓锐 滨州医学院附属医院山东 滨州 256600 256600
张兰兰 滨州医学院附属医院山东 滨州 256600 256600
张书懂 滨州医学院附属医院山东 滨州 256600 256600
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中文摘要:
      目的 系统评价阿戈美拉汀治疗首发抑郁障碍患者的效果和安全性,以期为抑郁障碍的药物治疗提供参考。方法 检索PubMed、Web of Science、中国学术期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库中关于阿戈美拉汀治疗首发抑郁障碍患者的临床随机对照研究,提取阿戈美拉汀与SSRIs/ SNRIs类抗抑郁药物在治疗首发抑郁障碍的效果和安全性的数据,采用RevMan 5.3进行Meta分析。结果 共纳入12篇文章,其中中文10篇,英文2篇。Meta分析结果显示,治疗后阿戈美拉汀组与对照组HAMD-17评分差异有统计学意义(SMD=-1.31,95% CI:-1.55~-1.07,Z=10.77,P<0.01)。由于研究间异质性较大(I2=83%,P<0.01),根据对照组所采用抗抑郁药种类进行亚组分析,分别以氟西汀(SMD=-1.22,95% CI:-1.66~-0.77,Z=5.30,P<0.01)、度洛西汀(SMD=-0.88,95% CI:-1.26~-0.50,Z=4.49,P<0.01)为对照的研究治疗后HAMD-17评分与阿戈美拉汀组差异均有统计学意义。关于副作用的Meta分析显示,阿戈美拉汀组与对照组之间差异有统计学意义(RR=0.63,95% CI:0.49~0.80,Z=3.73,P<0.01)。结论 阿戈美拉汀治疗首发抑郁障碍的疗效优于SSRIs/SNRIs类抗抑郁药物或与其疗效相当,副作用小于SSRIs/SNRIs类抗抑郁药物。
英文摘要:
      Objective To systematically assess the efficacy and safety of agomeltine in the treatment of first-episode depression, so as to provide references for drug treatment of depression.Methods Randomized controlled trials (RCTs) related to agomeltine in the treatment of first-episode depression published in PubMed, Web of Science, CNKI, VIP, and Wangfang were retrieved.Extracted data on the efficacy and safety of agomelatine and SSRIs/SNRIs in the treatment of first-episode depression,and the collected data were processed by RevMan 5.3 software.Results A total of 12 RCTs were included (10 in Chinese and 2 in English). Meta-analysis showed that the HAMD-17 scores of agomelatine group were statistically different from those of control group (SMD=-1.31, 95% CI: -1.55~-1.07, Z=10.77, P<0.01). High heterogeneity was found in control group (I2=83%, P<0.01), so subgroup analysis was further performed, and the results indicated that HAMD-17 scores of fluoxetine subgroup (SMD=-1.22, 95% CI: -1.66~-0.77, Z=5.30, P<0.01) and duloxetine subgroup (SMD=-0.88, 95% CI: -1.26~-0.50, Z=4.49, P<0.01) showed significant different with those of agomelatine group. The incidence of side effects were statistically different between groups (RR=0.63, 95% CI: 0.49~0.81, Z=3.73, P<0.01).Conclusion Agomelating is superior or comparable to SSRIs/SNRIs antidepressants in the treatment of first-episode depression, and has fewer side effects than SSRIs/SNRIs antidepressants.
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