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奥卡西平辅助治疗精神分裂症对照研究:国内文献的Meta分析

金卫东,金锐   

  1. 浙江省立同德医院,
  • 收稿日期:2018-10-22 修回日期:2018-12-13 出版日期:2018-12-25 发布日期:2018-12-25

Comparison Study of Oxcarbazepine in Adjunctive Treatment of Schizophrenia with Excitement: Results from Domestic Dada Meta-analysis

.Department of Pharmacology and   

  1. Tongde hospital of Zhejiang province,Zhejiang Chinese Medical University;Department of Psychiatry,Tongde hospital of Zhejiang province,zhejiang province mental health center;Corresponder: wdjin@com
  • Received:2018-10-22 Revised:2018-12-13 Online:2018-12-25 Published:2018-12-25

摘要: 目的:评价分析奥卡西平辅助治疗精神分裂症的疗效。方法:通过数据检索,对5项奥卡西平和抗精神病药物联用,与单一抗精神病药物治疗精神分裂症的研究资料进行Meta分析,评价有效率和症状改善的差异。结果:1.症状学变化:阳性症状和阴性症状评定量表(PANSS)所表示的兴奋症状,奥卡西平组显著低于对照组(异质性检验, χ2=49.02,df=6,P=0.001,I2=87.8%,采用随机效应模型,WMD=-3.37,95%CI=-3.94~-2.81,Z=11.67,P<0.001),奥卡西平组外显行为评定量表(MOAS)显著低于对照组(异质性检验, χ2=60.76,df=4,P=0.001,I2=93.4%, 采用随机效应模型,WMD=-2.16,95%CI=-2.49~-1.83,Z=12.84,P<0.001),简明精神病评定量表(BPRS)所表示的兴奋症状,奥卡西平组显著低于对照组(异质性检验, χ2=2.86,df=7,P=0.90,I2=0%, 采用固定效应模型,WMD=-6.04,95%CI=-7.56~-4.52,Z=7.80,P<0.001)。2.有效率:通过异质性检验, χ2=2.45,df=3,P=0.48,I2=0%,采用固定效应模型,OR=1.65,95%CI=1.09~2.49,Z=2.39,P=0.02,提示奥卡西平治疗兴奋型精神分裂症有效率提高,且有统计学意义。3.痊愈率:异质性检验,χ2=0.66,df=2,P=0.66,I2=0%,采用随机效应模型,OR=1.07,95%CI=0.50~2.29,合并效应检验:Z=0.18,P=0.86,提示奥卡西平治疗精神分裂症并没有提高痊愈率。结论:奥卡西平辅助治疗精神分裂症有效,特别有利于控制兴奋状态。

Abstract: Objective:To analyze the effects of Oxcarbazepine adjunctive treatment of schizophrenia with excitement. Methods:The effective rate and symptom change were assessed between two groups (Oxcarbazepine vs without Oxcarbazepine) in 5 studies from searching Chinese medical database. Results: 1.The scale of excitement symptoms: The excitement of PANSS(positive and negative symptoms scale) was lower significantly in Oxacarbazepine than that of without Oxcarbazepine(test for heterogeneity: χ2=49.02,df=6,P=0.001, I2=87.8%, random effect model: WMD=-3.37, 95%CI=-3.94~-2.81, Z=11.67,P<0.001). The excitement of Moas(Modified Overt Aggression Scale) was lower significantly in Oxacarbazepine than that of without Oxcarbazepine(test for heterogeneity: χ2=60.76, df=4,P=0.001,I2=93.4%, random effect model: WMD=-2.16, 95%CI=-2.49~-1.83,Z=12.84,P<0.001). The excitement of BPRS(brief psychotic rating scale) was lower significantly in Oxacarbazepine than that of without Oxcarbazepine(test for heterogeneity: χ2=2.86, df=7,P=0.90,I2=0%, fixed effect model: WMD=-6.04,95%CI=-7.56~-4.52,Z=7.80,P<0.001). 2. The higher effective rate was found in Oxacarbazepine group than that without Oxcarbazepine group(test for heterogeneity: χ2=2.45, df=3, P=0.48, I2=0%, fixed effect model: OR=1.65,95%CI=1.07~2.49, Z=2.39,P=0.02). 3.The recovery rate has not improved between two group (test for heterogeneity: χ2=0.66,df=2, P=0.66,I2=0%, fixed effect model: OR=1.07, 95%CI=0.50~2.29, Z=0.18, P=0.86). Conclusion: The Oxcarbazepine was better in adjunctive treatment in schizophrenic patients with excitement symptom.