利培酮联合舍曲林治疗精神分裂症阴性症状 疗效和安全性的Meta分析

目的 系统评价利培酮联合舍曲林治疗精神分裂症阴性症状的疗效和安全性。方法 计算机检索PubMed、EMbase、The Cochrane Library、CBM、WanFang Data和CNKI数据库，搜集有关利培酮联合舍曲林治疗精神分裂症阴性症状疗效和安全性的随机对照试验（RCT），检索时限从2007年1月~2017年9月。由两位评价员独立筛选文献、摄取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3软件进行Meta分析。结果 最终纳入10个RCT，包括703个患者。Meta分析结果显示:与单用利培酮相比，利培酮联合舍曲林能明显提高有效率RR=1.39，95%CI（1.26，1.54），P＜0.00001]，降低阳性与阴性统计量表（PANSS）总分SMD=-0.46，95%CI（-0.69，-0.22），P=0.0001]及其阴性分SMD=-0.73，95%CI（-0.98，-0.49），P＜0.00001]，降低阴性症状量表（SANS）评分SMD=-0.67，95%CI（-0.91，-0.43），P＜0.00001]；对集中报道的不良反应（失眠、视物模糊，锥外体系反应、口干）发生率进行比较，差异无统计学意义（P＞0.05）。结论 利培酮联合舍曲林能提高对精神分裂症阴性症状的疗效，并不增加不良反应发生率。受纳入研究质量的限制，上述结论尚需开展更多高质量的研究予以验证。

Meta Analysis of Efficacy and Safety of Risperidone Combined with Sertraline in the Treatment of Schizophrenia with Negative Symptoms

Abstract:Objective To systematically evaluate the efficacy and safety of risperidone and sertraline in the treatment of negative symptoms of schizophrenia.Methods Computer searches PubMed,EMbase,The Cochrane Library,CBM,WanFang Data and CNKI databases to collect randomised controlled trials(RCT)on the efficacy and safety of risperidone and sertraline in the treatment of negative symptoms of schizophrenia.The search period is from January 2007 to September 2017.Two reviewers independently selected literature,ingested data,and assessed the risk of bias into the study,using RevMan 5.3 software for meta-analysis.Results The final inclusion of 10 RCT included 703 patients.Meta-analysis showed that risperidone combined with sertraline significantly increased the efficacy compared with risperidone aloneRR=1.39,95%CI(1.26,1.54),P<0.00001],and decreased positive and negative statistics. (PANSS)total scoreSMD=-0.46,95% CI (-0.69,-0.22),P=0.0001]and its negative scoreSMD=-0.73,95% CI(-0.98,-0.49),P<0.00001], Reduced Negative Symptom Scale(SANS)scoreSMD=-0.67,95%CI(-0.91,-0.43),P<0.00001];There was no significant difference in the incidence of adverse reactions(insomnia,blurred vision,extra-conical system reaction,and dry mouth)reported in a concentrated manner (P>0.05).Conclusion Risperidone combined with sertraline can improve the efficacy of negative symptoms of schizophrenia without increasing the incidence of adverse reactions.Due to the limitations of the quality of the included studies,the above conclusions still need to be verified by more high-quality research.