中西医结合治疗癫痫伴抑郁Meta分析

目的:系统评价中西医结合治疗癫痫伴抑郁患者的临床疗效。方法:计算机检索中国知网、万方数据库、中国医学生物文献数据库、维普资讯、PubMed及Web of Science等中英文数据库,筛选出自各数据库建库以来至2018年7月关于中西医结合治疗癫痫伴抑郁的临床随机对照试验(randomized controlled trial,RCT)研究,根据系统评价标准依次进行文献质量评价和Meta分析。结果:纳入14个研究,共1183例患者。Meta分析结果显示:中西医结合治疗癫痫伴抑郁在降低HAMD评分、提高QLOIE-31评分方面优于单纯西药治疗。癫痫发作频次改善率效应值合并量OR=3.53,95%CI(1.73,7.17),Z=3.48(P=0.0005),差异有统计学意义(P<0.05)。临床安全性效应值合并量OR=0.59,95%CI(0.35,0.98),Z=2.03(P=0.04),差异有统计学意义(P<0.05)。结论:中西医结合足疗程治疗癫痫伴抑郁临床疗效优于单纯西药治疗,且临床安全性良好,但因纳入研究数量和质量有限,上述结论尚待高质量的RCT研究验证。

An Meta Analysis of Epilepsy Combined with Depression Treated with Integrated Traditional Chinese and Western Medicine

Objective:To systematically evaluate the clinical effect of integrated traditional Chinese and Western Medicine on epilepsy patients combined with depression.Methods:The Chinese and English databases of CNKI,Wanfang database,Chinese medical biological literature database,VIP information,PubMed,Web of Science,etc.were searched by computer,and the randomized controlled trial(RCT)research on the treatment of epilepsy combined with depression by the integrated traditional Chinese and Western medicine was screened from the database establishment to July 2018.Then the literature quality evaluation and Meta analysis were carried out successively according to the system evaluation standard.Results:A total of 14 studies were included,including 1,183 patients.The Meta analysis showed that the combination of traditional Chinese and Western medicine in the treatment of epilepsy combined with depression was better than Western medicine alone in reducing HAMD score and improving QLOIE-31 score.The improvement rate effect value of epileptic attack frequency was:OR=3.53,95%CI(1.73,7.17),Z=3.48,the difference was statistically significant(P=0.0005).The clinical safety effect value was:OR=0.59,95%CI(0.35,0.98),Z=2.03,the difference was statistically significant(P=0.04).Conclusion:The clinical efficacy of the treatment of epilepsy combined with depression treated with integrated traditional Chinese and Western medicine is better than that by Western medicine alone,and the clinical safety is good.However,due to the limited quantity and quality of the study,the above conclusions need to be verified by high-quality RCT study.