摘要
目的 对艾司西酞普兰治疗抑郁症的系统评价/Meta分析进行再评价,以期为该药的临床应用提供参考。方法 计算机检索中国知网、万方数据库、维普网、SinoMed、PubMed、Cochrane Library等数据库中艾司西酞普兰治疗抑郁症的系统评价/Meta分析,检索时限为建库至2022年5月17日。根据纳排标准筛选文献,提取纳入文献的基本信息,使用AMSTAR 2量表、PRISMA声明、GRADE系统分别对纳入文献的方法学质量、报告质量与证据质量进行评价。结果 共纳入16篇系统评价/Meta分析,有效性比较结果表明,艾司西酞普兰治疗抑郁症在提高总有效率方面,疗效不劣于舍曲林,与度洛西汀、氟西汀等效果相当;在提高痊愈率方面,与帕罗西汀、度洛西汀及氟西汀等效果相当;安全性比较结果表明,艾司西酞普兰的安全性高于帕罗西汀、文拉法辛等。AMSTAR 2量表方法学质量评价整体偏低,均评价为极低级,多条关键条目的缺失是主要原因;PRISMA得分在12~23分之间,其中得分>21分的有5篇文献,报告相对完整,得分在15~21分的有10篇文献,报告具有一定的缺陷,得分≤15分的有1篇文献,信息缺失严重;GRADE证据分级结果显示,纳入的160个结局指标中,69个为中级证据,64个为低级证据,27个为极低级证据。结论 艾司西酞普兰提高抑郁症患者总有效率不劣于舍曲林;相较于帕罗西汀,艾司西酞普兰等安全性更高。但上述结论证据等级较低。
OBJECTIVE To re-evaluate systematic review/meta-analysis of escitalopram in the treatment of depression, and to provide reference for clinical use of escitalopram. METHODS Retrieved from CNKI, Wanfang database, VIP, SinoMed, PubMed and the Cochrane Library, etc., systematic review/meta-analysis of escitalopram in the treatment of depression were collected from the construction of the database to May 17, 2022. The literatures were screened according to the inclusion and exclusion criteria, the basic information of the included literatures was extracted, and the methodological quality, reporting quality and evidence quality of the included literatures were evaluated by using AMSTAR 2 scale, PRISMA statement, and GRADE system, respectively. RESULTS A total of 16 systematic reviews/meta-analyses were included. The results of efficacy comparison showed that escitalopram in the treatment of depression was superior to sertraline in improving the total effective rate, and was comparable to paroxetine, duloxetine and fluoxetine in improving cure rate. The results of safety comparison showed that the safety of escitalopram was higher than that of paroxetine and venlafaxine. The overall methodological quality evaluation of AMSTAR 2 scale was low, and all of them were rated as extremely low;main reason was the lack of many key items. PRISMA score was between 12 and 23 points. Among them, there were 5 literatures with scores >21 points, and the reports were relatively complete, 10literatures with scores between 15 and 21 points, and the reports had certain defects, and 1 literature with scores ≤15 points, with serious information missing. The results of the grading of GRADE evidence showed that, of the 160 included outcome indicators, 69 were moderate evidence, 64 were low-level evidence, and 27 were very low-level evidence. CONCLUSIONS The total effective rate of escitalopram in improving depressive patients is not inferior to that of sertraline;compared with paroxetine, escitalopram is safer. However, the evidence level of the above conclusions is low.
作者
李会全
李小江
张雪娟
LI Huiquan;LI Xiaojiang;ZHANG Xuejuan(Dept.Two of Psychiatry,the Sixth People’s Hospital of Jiyuan,Henan Jiyuan 454650,China)
出处
《中国药房》
CAS
北大核心
2023年第1期91-96,共6页
China Pharmacy
基金
河南省科技攻关项目(No.212102310588)。
关键词
艾司西酞普兰
抑郁症
系统评价再评价
循证医学
escitalopram
depression
overview of systematic review
evidence-based medicine
