噻奈普汀与SSRI类药物比较治疗抑郁症有效性和安全性Meta分析

Efficacy and safety of Tianeptine versus SSRI in the treatment of depression：a Meta analysis

摘要:

目的：评价噻奈普汀与选择性五羟色胺再摄取抑制剂（selective serotonin reuptake inhibitor，SSRI）治疗抑郁症的有效性和安全性。方法：通过检索Cochrane Library、PubMed、Web of knowledge、Embase，中国生物医学文献数据库（CBM）、中国学术期刊全文数据库（CNKI）、万方数据库（CECDB）、维普中文科技期刊全文数据库（CQVIP），筛选随机对照试验（randomized controlled trials，RCTs），并对纳入文献进行质量评价和数据提取，用Review manager 5.2软件对纳入的RCTs进行Meta分析。结果：纳入12个RCTs共2 143名患者，其中噻奈普汀治疗组1 086例，SSRI药物治疗组1 057例。Meta分析结果指出噻奈普汀治疗组患者有效率与SSRI药物治疗组有效率，无统计学差异（有效率 RR=1.01，95%CI=0.95～1.07，P=0.85），且噻奈普汀治疗组恶心、呕吐、便秘、失眠与食欲减退的发生率明显低于SSRI药物治疗组（P<0.05），而嗜睡的发生率高于SSRI药物治疗组；其余的副反应发生率比较均无统计学意义（P >0.05）。结论：虽然噻奈普汀治疗抑郁症与SSRI药物治疗抑郁症的疗效没有统计学意义，但是其副反应明显低于SSRI类药物，故对临床用药有一定的指导意义。

Abstract:

Objective：To access the efficacy and safety of Tianeptine versus selective serotonin reuptake inhibitor（SSRI） in the treatment of depression. Methods：Randomized controlled trials（RCTs） in relevant databases：Cochrane Library，PubMed，Web of Knowl－edge，Embase，China Biology Medicine Literature，China National Knowledge Internet，Wanfang Data and VIP were searched. Quality of the included literature was evaluated and data were extracted. Review Manager 5.2 software was used for Meta analysis. Results：Twelve RCTs of 2 143 patients were included in our study，1 086 patients in Tianeptine group and 1 057 patients in SSRI group. Meta-analysis results indicated that there was no difference in efficiency between Tianeptine group and SSRI group（effective rate RR=1.01，95%CI=0.95 to 1.07，P=0.85）. Incidences of nausea，vomiting，constipation，insomnia and loss of appetite were significantly lower in Tianeptine group than in SSRI group（P<0.05） while incidence of somnolence was higher in Tianeptine group than in SSRI group. There was no statistical difference in other side effects between the two groups（P >0.05）. Conclusion：Although no statistical difference is observed in the efficacy between Tianeptine and SSRI，however，Tianeptine induces fewer side reactions，there of clinical guiding significance.