西酞普兰与阿米替林治疗卒中后抑郁障碍的Meta分析

目的:系统评价西酞普兰与阿米替林治疗卒中后抑郁障碍(PSD)的有效性和安全性。方法:计算机检索Cochrane library、Medline、EMbase、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库,查找西酞普兰与阿米替林治疗PSD的随机对照试验(RCT),对纳入的RCT进行质量评价,并采用Rev Man5.1软件进行Meta分析。结果:共纳入18项RCT,包括1040例PSD患者。Meta分析结果显示,治疗6周后西酞普兰组的有效率优于阿米替林组[RR=1.10,95%CI(1.02,1.18),P=0.01];治疗8周后2组的有效率比较差异无统计学意义[RR=1.05,95%CI(0.97,1.14),P=0.19];治疗1、2、4、6周后西酞普兰组汉密尔顿抑郁量表评分改善优于阿米替林组;治疗2、4、6、8周后西酞普兰组的治疗副反应量表评分优于阿米替林组。结论:西酞普兰治疗PSD疗效与阿米替林相当,但改善抑郁症状较阿米替林快,安全性优于阿米替林。

Meta-analysis of Citalopram and Amitriptyline for Post-stroke Depression

OBJECTIVE： To evaluate the efficacy and safety of citalopram and amitriptyline for post-stroke depression （PSD）. METHODS： Randomized controlled trials （RCT） focused on citalopram vs. amitriptyline in the treatment of PSD were searched from the databases including： Cochrane Library, Medline, EMbase, CBM, VIP, CNKI and Wanfang database. The qualities of in- cluded RCTs were evaluated by means of RevMan 5.1 to conduct the Meta-analysis. RESULTS： A total of 18 RCTs were included, involving 1 040 PSD patients. Meta-analysis results disclosed that the effectiveness of citalopram group was better than that of amitriptyline group after 6 weeks treatment [RR： 1.10, 95%CI （1.02,1.18）,P=0.01]; the effectiveness of the 2 groups had no significant differences after 8 weeks treatment [RR = 1.05, 95 % CI （0.97, 1.14）, P= 0.19]; compared with amitriptyline group, citalopram group not only presented advantages that improvement of Hamilton Depression Rating Scale score after 1, 2, 4, 6 weeks treatment, but also existed advantages that improvement of side effects scale score 2, 4, 6, 8 weeks after treatment. CONCLUSION： The effect of citalopram is equivalent to amitriptyline, whereas it＇ s faster and safer than amitriptyline in the treatment of PSD.