阿立哌唑与氯氮平治疗精神分裂症Meta分析

目的：了解阿立哌唑与氯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17项研究阿立哌唑与氯氮平治疗精神分裂症对照研究的文章进行再分析,重新评价其疗效和不良反应。结果：阿立哌唑组治疗前后的自身对照,合并效应量d=3.62,95%CI（0.607,6.63）,综合显著性检验χ^2=8.52,P〈0.01,提示阿立哌唑治疗精神分裂症前后症状学变化差异有显著性,效应极强;阿立哌唑组与氯氮平组之间组间比较,d=0.043,95%CI（0.013,0.153）,综合显著性检验χ2=4.65,P〈0.05,提示这两种药物的疗效差异有统计学意义,差异效应很弱;阿立哌唑组的失眠,头痛不良反应显著较比氯氮平组多,（χ^2=27.95,P〈0.001;χ^2=15.54,P〈0.001）,氯氮平组的流涎、白细胞减少、嗜睡、体质量增加、便秘、心动过速、头晕等不良反应均显著较比阿立哌唑组为多（χ^2=39.11~360.60,P均〈0.001）。结论：阿立哌唑在平均8周左右的疗效显著优于氯氮平,不良反应却有显著不同。

Meta-analysis on aripiprazole and clozapine in treating schizophrenia

Objective： To study the difference in therapeutic effects and side effects between aripiprazole and clozapine on schizophrenia. Method： 17 studies that compare effects of aripiprazole and clozapine in treating schizophrenia were analyzed by meta-analysis to reevaluate the therapeutic effects and side effects of the two drugs. Results：The significant difference in change of symptom before and after treatment by aripiprazole was found （ d = 3.62,95% CI（0. 60 - 6.63 ）, Χ^2 = 8.52, P 〈 0.01 ）, indicating that aripiparozole has good effect on schizophrenia;group comparison results between aripiprazole and clozapine suggested that the two drugs had significant difference in the efficacy even though very weak （d = 0. 043,95 % CI（0. 013 -0. 153 ）, Χ^2 = 4.65,P 〈 0.05 ）;The incidence of insomnia and headache in aripiprazole group were significantly higher than clozapine group （ Χ^2 = 27.95, P 〈 0. 001 ; X2 = 15.54, P 〈 0.01 ） , but that of salivate, leueoeytopenia, sommolence, increasing in weight, constipation, sinus tachycardia and dizzying in aripiprazole group were lower than that in clozapine group （ Χ^2 = 39.11 - 360.60, P 〈 0. 001 ）. Conclusion ： Aripiprazole has showed a better effect than clozapine at an average of about eight weeks treatment and significantly different side effects.