高頻左側(cè)重復(fù)經(jīng)顱磁刺激與電休克治療抑郁癥隨機(jī)對照試驗(yàn)的meta分析
發(fā)布時(shí)間：2019-01-01 13:47
【摘要】：背景：既往研究對于高頻左側(cè)重復(fù)經(jīng)顱磁刺激（HFL-rTMS）和電休克療法（ECT）的抗抑郁療效有不同的比較結(jié)果，本研究試圖通過循證醫(yī)學(xué)的方法系統(tǒng)評(píng)價(jià)二者的療效性，并且探討HFL-rTMS是否能夠代替ECT治療抑郁癥。方法：我們在以下數(shù)據(jù)庫中進(jìn)行了系統(tǒng)的文獻(xiàn)檢索（PubMed，CCTR，Web of Science，Embase，CBM-disc和CNKI），文獻(xiàn)檢索日期截止至2012年10月。將有效率和緩解率作為主要評(píng)價(jià)指標(biāo)。使用隨機(jī)效應(yīng)模型和比值比（ORs）進(jìn)行統(tǒng)計(jì)分析。結(jié)果：共篩選出7篇文獻(xiàn)，，7項(xiàng)RCTs納入共262例抑郁患者。全部研究均報(bào)道了有效率，其中HFL-rTMS治療組135人，有67人治療有效（49.6%）；ECT治療組127人，有78人治療有效（61.4%）[OR=0.64，95%CI（0.30,1.38），z=1.13，p=0.26]。有6項(xiàng)RCTs報(bào)道了痊愈率，其中HFL-rTMS治療組115人，有39人治療有效（33.9%）；ECT治療組107人，有47人治療有效（43.9%）[OR=0.66，95%CI（0.33,1.32），z=1.19，p=0.24]。兩組患者間入組時(shí)的抑郁評(píng)分以及失訪率均沒有統(tǒng)計(jì)差異。沒有發(fā)現(xiàn)顯著的異質(zhì)性和潛在的發(fā)表偏倚。結(jié)論：當(dāng)HFL-rTMS與ECT都作為單一治療方式時(shí)，他們對抑郁癥的治療效果沒有統(tǒng)計(jì)學(xué)差異。但考慮到HFL-rTMS花費(fèi)更少且副作用少，它可以被期待成為ECT的替代療法。未來研究應(yīng)一步探索HFL-rTMS療效的長期維持，以及HFL-rTMS與其他刺激模式的rTMS的療效對比，從而尋找最佳的rTMS參數(shù)設(shè)置。
[Abstract]:Background: previous studies have compared the antidepressant effects of high frequency left side repetitive transcranial magnetic stimulation (HFL-rTMS) with electroshock therapy (ECT). This study attempts to systematically evaluate their efficacy through evidence-based medicine. And to explore whether HFL-rTMS can replace ECT in the treatment of depression. Methods: we conducted systematic literature retrieval in the following databases (PubMed,CCTR,Web of Science,Embase,CBM-disc and CNKI), as of October 2012). Efficiency and mitigation rate as the main evaluation indicators. Stochastic effect model and ratio (ORs) were used for statistical analysis. Results: a total of 7 articles were selected and 7 items of RCTs were included in 262 patients with depression. The effective rate was reported in all the studies, of which there were 135 patients in the HFL-rTMS treatment group, 67 of whom were effective (49.6%). In the ECT treatment group, 78 patients (61.4%) were effective [OR=0.64,95%CI (0.301.38), ZD 1.13p 0.26]. The cure rate was reported by 6 items of RCTs, of which there were 115 cases in HFL-rTMS group and 39 cases were effective (33.9%). In the ECT treatment group, 47 patients were effective (43.9%) [OR=0.66,95%CI (0.33 鹵1.32), ZD 1.19 p0. 24]. There was no statistical difference in depression score and loss rate between the two groups. No significant heterogeneity and potential publication bias were found. Conclusion: there was no significant difference in the efficacy of HFL-rTMS and ECT in the treatment of depression. But given the lower cost and less side effects of HFL-rTMS, it could be expected to be an alternative to ECT. The future study should explore the long-term maintenance of the efficacy of HFL-rTMS and the comparison of the efficacy of HFL-rTMS with other stimulation modes of rTMS in order to find the best setting of rTMS parameters.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.41
本文編號(hào)：2397655
[Abstract]:Background: previous studies have compared the antidepressant effects of high frequency left side repetitive transcranial magnetic stimulation (HFL-rTMS) with electroshock therapy (ECT). This study attempts to systematically evaluate their efficacy through evidence-based medicine. And to explore whether HFL-rTMS can replace ECT in the treatment of depression. Methods: we conducted systematic literature retrieval in the following databases (PubMed,CCTR,Web of Science,Embase,CBM-disc and CNKI), as of October 2012). Efficiency and mitigation rate as the main evaluation indicators. Stochastic effect model and ratio (ORs) were used for statistical analysis. Results: a total of 7 articles were selected and 7 items of RCTs were included in 262 patients with depression. The effective rate was reported in all the studies, of which there were 135 patients in the HFL-rTMS treatment group, 67 of whom were effective (49.6%). In the ECT treatment group, 78 patients (61.4%) were effective [OR=0.64,95%CI (0.301.38), ZD 1.13p 0.26]. The cure rate was reported by 6 items of RCTs, of which there were 115 cases in HFL-rTMS group and 39 cases were effective (33.9%). In the ECT treatment group, 47 patients were effective (43.9%) [OR=0.66,95%CI (0.33 鹵1.32), ZD 1.19 p0. 24]. There was no statistical difference in depression score and loss rate between the two groups. No significant heterogeneity and potential publication bias were found. Conclusion: there was no significant difference in the efficacy of HFL-rTMS and ECT in the treatment of depression. But given the lower cost and less side effects of HFL-rTMS, it could be expected to be an alternative to ECT. The future study should explore the long-term maintenance of the efficacy of HFL-rTMS and the comparison of the efficacy of HFL-rTMS with other stimulation modes of rTMS in order to find the best setting of rTMS parameters.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.41
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
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2 馬辛;李淑然;向應(yīng)強(qiáng);郭紅利;侯也之;蔡焯基;李振波;李占江;陶玉芬;黨衛(wèi)民;吳曉梅;鄧晶;;北京市抑郁癥的患病率調(diào)查[J];中華精神科雜志;2007年02期
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