阿立哌唑与喹硫平治疗老年精神分裂症的循证药物经济学评价

目的 比较分析阿立哌唑与喹硫平治疗老年精神分裂症疗效、不良反应及药物经济性。方法 检索中国期刊全文数据库（CNKI）、维普中文科技期刊全文数据库（VIP）、万方医学网、PubMed、EBSCO、OVID等数据库中阿立哌唑与喹硫平药治疗老年精神分裂症的临床随机对照试验，检索时限为建库至2017年9月。采用循证医学方法对2种药品进行疗效及不良反应分析，并应用药物经济学分析法评价其经济性。结果 纳入10篇RCT，Meta-分析结果显示：阿立哌唑与喹硫平治愈率差异无统计学意义（P>0.05），采用成本-效果分析法进行药物经济学分析；药物不良反应发生率方面，便秘RR=0.39，95%CI（0.16~0.95）]、嗜睡RR=0.32，95%CI（0.16~0.62）]及头晕RR=0.47，95%CI（0.27~0.81）]差异有统计学意义（P<0.05），其他不良反应差异无统计学意义（P>0.05）。成本-效果比分别为57.97%、31.32%。结论 阿立哌唑与喹硫平治疗老年精神分裂症在疗效相当的情况下，喹硫平的用药花费相对较低，但发生便秘、嗜睡及头晕风险相对较高，临床医师在用药选择时，可根据患者实际情况个体化用药。

Aripiprazole and quetiapine in treatment of senile schizophrenia: A evidence-based drug economics evaluation

Objective To comparatively analyze the efficacy, adverse reactions, and drug economy of aripiprazole and quetiapine in the treatment of senile schizophrenia.Methods Databases including CNKI, VIP, Wanfang, PubMed, EBSCO, and OVID Database were searched to collect randomized controlled trials (RCTs) about the aripiprazole and quetipiapine in the treatment of the senile schizophrenia from database establishment to September 2017. The efficacy and adverse reactions of two drugs were analyzed by evidence-based medicine, and pharmacoeconomic analysis was used to evaluate their economic effectiveness.Results Ten RCTs were collected. Meta-analysis results showed that at the end of the treatment period, the cure rate of aripiprazole and quetipiapine was no significant difference (P>0.05). ConstipationRR=0.39, 95%CI(0.16-0.95)], drowsinessRR=0.32, 95%CI(0.16-0.62)] and dizzinessRR=0.47, 95%CI(0.27-0.81)] of adverse drug reactions were statistically significant (P<0.05), but there was no significant difference in other adverse reactions (P>0.05). The cost-effectiveness ratios were 57.97% and 31.32%.Conclusion Aripiprazole and quetiapine in the treatment of senile schizophrenia efficacy equivalent, quetiapine medication cost is relatively low, but the occurrence of constipation, drowsiness and dizziness, the risk is relatively high, clinicians in the drug selection, according to the actual situation of the patient individual choice.