帕利哌酮与奥氮平治疗精神分裂症对照研究的Meta分析

目的:了解帕利哌酮与奥氮平治疗精神分裂症的疗效和不良反应差异。方法:应用Meta分析对8项文献研究帕利哌酮与奥氮平治疗精神分裂症对照研究的文章进行再分析,评价其合并效应量的大小和综合显著性检验。结果:帕利哌酮治疗前后的自身对照,合并效应量d=4.322,95%CI(1.658,6.987),综合显著性检验x2=13.7,P<0.01,提示帕利哌酮治疗精神分裂症前后症状学变化有非常显著性差异,效应极强;帕利哌酮与奥氮平的组间比较,d=0.05,95%CI(-0.223,0.122),综合显著性检验x2=0.332,P>0.05,提示这两种药物的疗效无显著性统计学差异;帕利哌酮组的震颤、月经紊乱、肌张力障碍、静坐不能不良反应比奥氮平组多,差异具有显著性(x2=6.41～14.12,P均<0.01),便秘、心动过速、恶心呕吐不良反应无显著性差异,体重增加、嗜睡、肝功能异常不良反应均比奥氮平组少,有显著性差异(x2=5.94～37.65,P均<0.05)。结论:帕利哌酮与奥氮平在平均8周左右的疗效无显著性统计学差异,不良反应却有显著不同。

Comparative study on Paliperidone and Olanzapine in the treatment of schizophrenia with Meta-analysis

Objective:To study the difference in therapeutic effects and side effects between Paliperidone and Olanzapine.Methods:8 studies that compare effects differences in treated schizophrenia were analyzed by meta-analysis in therapeutic effects and side effects.Results: The significant difference in change of symptom before and after treatment by Paliperidone was found,d=4.322, 95%CI(1.658,6.987),x2=13.7,P<0.01;No significant difference in change of symptom between treatment by Paliperidone group and Olanzapine group,d=0.05,95%CI(-0.223,0.122),x2=0.332,P>0.05;The incidence of tremor、menoxenia、acute dystonia and akathisia in Paliperidone group were significantly different form Olanzapine group(x2=6.41~14.12,P<0.01),The incidence of constipation 、sinus tachycardia and nausea have not significant difference between Paliperidone group and Olanzapine group,but that of increasing in weight、sommolence and hepatic function abnormar in Paliperidone group were lower than in Olanzepine group(x2=5.94~37.65,P<0.05).Conclusions: No significant in change of symptom between treatment by Paliperidone group and Olanzapine group at an average of about eight weeks was found,but significantly different side effects.