噻奈普汀与阿米替林治疗抑郁症的系统评价

目的 系统评价噻奈普汀与阿米替林治疗抑郁症的疗效与安全性。方法 检索从建库至2016年3月，中国期刊全文数据库（CNKI）、万方数据库、中文科技期刊全文数据库（VIP）、Cochrane library、PubMed/Medline等数据库中噻奈普汀与阿米替林治疗抑郁症的随机对照试验（RCTs），采用RevMan 5.0软件对各效应指标进行Meta分析。结果 共纳入6篇RCTs，714例患者，其中噻奈普汀组（治疗组）359例，阿米替林组（对照组）355例；Meta分析结果显示噻奈普汀组与阿米替林组显效率差异无显著性[OR=1.56，95% CI（0.87~2.79），P=0.13]；两组头晕、口干、恶心呕吐、烦渴、便秘、震颤、排尿困难等不良反应差异有显著性（P<0.05），95% CI上下限均小于1，提示噻奈普汀组在上述不良反应发生率方面小于阿米替林组；其他不良反应无显著性差异。结论 噻奈普汀与阿米替林治疗抑郁症疗效相当，但噻奈普汀不良反应较轻微；该结论尚需高质量、严格设计的RCTs进一步证实。

Systematic review of tianeptine and amitriptyline in treatment of depression

Objective To evaluate the therapeutic effect and safety of tianeptine and amitriptyline in treatment of depression. Methods Retrieving from created datebase to March 2016 in Cochrane Library, PubMed/Medline, Chinese Journal Full-text Database (CNKI), Wanfang Database, and Chinese Science and Technology Journal Full-text Database (VIP) published on tianeptine and amitriptyline in the treatment of depression of randomized controlled trials(RCTs). Meta-analysis was carried out using RevMan 5.0 software to each effect index. Results A total of six articles were included in the RCTs, 714 patients, including tianeptine (treatment) group 359 cases and amitriptyline (control) group 355 cases. Meta-analysis results showed that there was no statistical significance in clinical efficacy between tianeptine and amitriptyline [OR=1.56, 95% CI (0.87-2.79), P=0.13]. In the incidence of adverse reactions, two groups had dizziness, dry mouth, nausea and vomiting, thirst, constipation, tremor symptoms, and there was significant difference of dysuria(P<0.05), 95% CI was less than 1, rhombus pattern was invalid in the left side of the line, suggesting that tianeptine group in the adverse reaction incidence rate was less than amitriptyline group, another no significant. Conclusion Tianeptine is as effective as amitriptyline for treatment of depression, but the adverse reaction of tianeptine is milder. However, high quality and large-scale RCTs are required for further study.