| 马明悦,刘燕,高洪彩,吉峰.非典型抗精神病药物联合选择性5-羟色胺再摄取抑制剂治疗难治性强迫症的效果与安全性的网状Meta分析[J].四川精神卫生杂志,2021,34(2):144-152.Ma Mingyue,Liu Yan,Gao Hongcai,Ji Feng,Efficacy and safety of atypical antipsychotics combined with selective serotonin reuptake inhibitors in the treatment of refractory obsessive-compulsive disorder： a network Meta-analysis[J].SICHUAN MENTAL HEALTH,2021,34(2):144-152 |
| 非典型抗精神病药物联合选择性5-羟色胺再摄取抑制剂治疗难治性强迫症的效果与安全性的网状Meta分析 |
| Efficacy and safety of atypical antipsychotics combined with selective serotonin reuptake inhibitors in the treatment of refractory obsessive-compulsive disorder： a network Meta-analysis |
| 投稿时间：2021-01-12 |
| DOI：10.11886/scjsws20210112001 |
| 中文关键词: 难治性强迫症 非典型抗精神病药 选择性5-羟色胺再摄取抑制剂 网状Meta分析 |
| 英文关键词:Refractory obsessive-compulsive disorder Atypical antipsychotics Selective serotonin reuptake inhibitors Network Meta-analysis |
| 基金项目:精神病与精神卫生专业学位硕士研究生临床能力的评价标准与体系的量化研究（项目编号：SDYY18195） |
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| 目的 采用网状Meta分析的方法评价7种非典型抗精神病药物联合选择性5-羟色胺再摄取抑制剂（SSRIs）治疗难治性强迫症的效果与安全性。方法 计算机检索CNKI、万方数据知识服务平台、维普数据库、中国生物医学文献数据库、PubMed、Embase和Cochrane Library数据库，按照纳入及排除标准收集非典型抗精神病药物联合SSRIs治疗难治性强迫症的随机对照试验，检索时间为建库至2020年6月，由两名研究者筛选文献、资料提取并评价纳入研究的偏倚风险，对符合标准的研究采用Stata 15.0进行数据分析。结果 共纳入36项随机对照研究，包括7种非典型抗精神病药物，共2 362例患者。网状Meta分析结果显示，在总有效率方面，曲线下累计排序概率面积（SUCAR）由高到低依次为奥氮平+SSRIs、帕利哌酮+SSRIs、氨磺必利+SSRIs、利培酮+SSRIs、喹硫平+SSRIs、齐拉西酮+SSRIs、阿立哌唑+SSRIs、单用SSRIs、安慰剂+SSRIs。在汉密尔顿焦虑量表（HAMA）评分方面，SUCAR由高到低依次为氨磺必利+SSRIs、阿立哌唑+SSRIs、喹硫平+SSRIs、利培酮+SSRIs、SSRIs。在副反应量表（TESS）评分方面，SUCAR由高到低依次为氨磺必利+SSRIs、单用SSRIs、帕利哌酮+SSRIs、喹硫平+SSRIs、齐拉西酮+SSRIs、利培酮+SSRIs、阿立哌唑+SSRIs、安慰剂+SSRIs。结论 非典型抗精神病药物联合SSRIs治疗难治性强迫症的效果与安全性均优于单用SSRIs类药物，其中奥氮平联合SSRIs的疗效最佳，氨磺必利联合SSRIs的安全性最高。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of 7 atypical antipsychotics combined with selective serotonin reuptake inhibitors（SSRIs） in the treatment of refractory obsessive-compulsive disorder by network Meta-analysis.Methods Randomized controlled trials （RCTs） about atypical antipsychotics and SSRIs in the treatment of refractory obsessive-compulsive disorder were searched in CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and Cochrane Library databases from inception to June 2020. Based on inclusion and exclusion criteria， the literature screening， date extraction and assessing risk of bias were performed by two researchers independently. Then all statistical analyses were performed using Stata 15.0 software.Results A total of 36 RCTs covering 7 atypical antipsychotics and 2 362 patients were included. Network Meta-analysis showed that the surface under the cumulative ranking （SUCAR） of total response rate was the largest in Olanzapine + SSRIs， followed by Paliperidone + SSRIs， Amisulpride + SSRIs， Risperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Aripiprazole + SSRIs， SSRIs， and Placebo + SSRIs in turn. In terms of Hamilton Anxiety Scale （HAMA） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by Aripiprazole + SSRIs， Quetiapine + SSRIs， Risperidone + SSRIs， and SSRIs in turn. In terms of Treatment Emergent Symptom Scale （TESS） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by SSRIs， Paliperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Risperidone + SSRIs， Aripiprazole + SSRIs， and Placebo + SSRIs in turn.Conclusion Compared with single application of SSRIs， its combination with atypical antipsychotics achieves better efficacy and higher safety in treating refractory obsessive-compulsive disorder， with Olanzapine+SSRIs being the most effective and Amisulpride+SSRIs the safest. |
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