本文選題：度洛西汀 + 聯(lián)合治療　； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過Meta分析的方法評價(jià)度洛西汀聯(lián)合非典型抗精神病藥對比度洛西汀單藥治療軀體形式障礙的療效和安全性。方法:以度洛西汀、軀體形式障礙、軀體癥狀障礙為檢索詞。檢索Cochrane Library、Pubmed、中國知網(wǎng)、萬方等。納入度洛西汀聯(lián)合非典型抗精神病藥治療軀體形式障礙,觀察對象符合現(xiàn)有的軀體形式障礙診斷標(biāo)準(zhǔn)的臨床隨機(jī)對照實(shí)驗(yàn)。對納入研究采用Cochrane風(fēng)險(xiǎn)偏倚評估工具進(jìn)行質(zhì)量評價(jià),然后提取資料,采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:共納入10篇隨機(jī)對照試驗(yàn),其中4篇為度洛西汀聯(lián)合喹硫平對比單藥度洛西汀,2篇聯(lián)合氨磺必利對比單藥,2篇聯(lián)合奧氮平對比單藥,1篇聯(lián)合帕利哌酮對比單藥,1篇聯(lián)合阿立哌唑?qū)Ρ葐嗡�。使用Meta分析對患者軀體形式障礙治療的有效率、治愈率,漢密爾頓抑郁量表(HAMD-17)、漢密爾頓焦慮量表(HAMA)、癥狀自評量表(SCL-90)中軀體化因子進(jìn)行評估,結(jié)果顯示治療后聯(lián)合組有效率(RR 1.29,95%CI[1.19-1.40])、治愈率(RR 1.66,95%CI[1.26-2.19])明顯高于單藥組,HAMD(MD-4.47,95%CI[-5.16,-3.77])、HAMA(MD-3.44,95%CI[-4.16,-2.73])評分、軀體化因子分(MD-0.44,95%CI[-0.55,-0.33])明顯低于單藥組,TESS副反應(yīng)(惡心、嗜睡、頭暈、口干、乏力、食欲減退等)與單藥治療相當(dāng)。結(jié)論:本研究說明度洛西汀與以上5種非典型抗精神病藥聯(lián)合治療軀體形式障礙的療效優(yōu)于度洛西汀單藥治療。不良反應(yīng)與單藥治療相當(dāng)。由于非典型抗精神病藥種類多,納入研究少,還須要更多高質(zhì)量的研究。
[Abstract]:Objective: to evaluate the efficacy and safety of duloxetine combined with atypical antipsychotics in the treatment of somatoform disorders by meta-analysis. Methods: Doxetine, somatoform disorder and somatic symptom disorder were used as the key words. Search for Cochrane Library Pubmed. China knowledge Web, Wanfang et al. Doxetine combined with atypical antipsychotics was used to treat somatoform disorder. Cochrane risk bias assessment tool was used to evaluate the quality of the inclusion study. Then the data were extracted and Meta-analysis was carried out with Revman 5.3 software. Results: a total of 10 randomized controlled trials were conducted. Four of them were duloxetine combined with quinthiapine, single drug, ampicillin, olanzapine, single drug, palipiperone, single drug, combined with aripiprazole, single drug, single drug. The efficacy, cure rate, Hamilton Depression scale (HAMD-17), Hamilton anxiety scale (Hama), symptom Checklist 90 (SCL-90) and somatization factors were evaluated by Meta-analysis. The results showed that the effective rate (RR 1.2995 CI [1.19-1.40]), the cure rate (RR 1.6695 CI [1.26-2.19]) were significantly higher in the combined group than in the single drug group (MD-4.47 鹵95CI [-5.16 -3.77]). The score of somatization factor (MD-0.4495 CI [-0.55U -0.33]) was significantly lower than that in the monotherapy group (nausea, sleepiness, dizziness, fatigue, fatigue), and the score of somatization factor (MD-0.4495 CI [-0.55U -0.33]) was significantly lower than that in the monotherapy group (nausea, sleep, dizziness, fatigue). Loss of appetite, etc.) is comparable to single drug therapy. Conclusion: this study shows that the combination of doxicetine and the above five atypical antipsychotics for somatoform disorder is better than that of doloxetine alone in the treatment of somatoform disorder. Adverse reactions were comparable to single drug therapy. Because atypical antipsychotics have a large variety of drugs and few studies are included, more high-quality studies are needed.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749

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