小剂量三环类抗抑郁药治疗肠易激综合征疗效及安全性的荟萃分析

目的:系统评价三环类抗抑郁药治疗肠易激综合征的疗效和安全性.方法:计算机检索PubMed数据库、Cochrane图书馆临床对照试验数据库、中国生物医学文献数据库、中国期刊全文数据库,查找三环类抗抑郁药治疗肠易激综合征的双盲安慰剂随机对照试验,应用Cochrane协作网提供的Revman4.2软件进行分析评价.结果:共纳入8项试验,334例患者.治疗使用的药物包括阿米替林、米帕明、地昔帕明、多虑平、三甲丙咪嗪.高质量的随机对照试验表明,三环类抗抑郁药改善肠易激综合征总体症状缓解率(72.43%)明显高于安慰剂(40.76%)RR=1.79,95%CI=(1.48,2.17),P<0.05],改善腹痛评分疗效优于安慰剂SMD=-1.68,95%CI(-3.13,-0.23),P<0.05],不良反应的发生率与安慰剂组相比无明显统计学差异RR=1.34,95%CI=(0.91,1.96),P>0.05].结论:小剂量三环类抗抑郁药对减轻肠易激综合征患者的各种症状、特别是缓解腹痛方面是有效和安全的.

Efficacy and safety of low-dose tricyclic antidepressants in patients with irritable bowel syndrome: a meta-analysis

AIM: To systematically assess the efficacy and safety of low-dose tricyclic antidepressants (TCAs) for irritable bowel syndrome (IBS). METHODS: PubMed, The Cochrane Central Register of Controlled Trials and Chinese Biomedical Literature Database, and CNKI were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. The Revman4.2 software provided by the Cochrane Collaboration was used for assessment. RESULTS: Eight placebo-controlled, doubleblind, ra...