MECT联合SSRI类药物治疗难治性抑郁症有效性和安全性Meta分析

Efficacy and safety of MECT plus SSRI in the treatment of refractory depression：a Meta analysis

摘要:

目的：评价改良电休克（modified electroconvulsive therapy，MECT）联合选择性５－羟色胺再摄取抑制剂（selective sero－tonin reuptake inhibitor，SSRI）治疗难治性抑郁症的有效性和安全性。方法：通过检索Cochrane Library、PubMed、Web of Knowl－edge、EBSCO、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），检索年限不限，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 5.0软件对纳入的RCTs进行Meta分析。结果：纳入7个RCTs共461名患者，其中MECT联合治疗组230例，SSRI药物治疗组231例。Meta分析结果指出MECT联合治疗组患者治愈率和有效率均高于SSRI药物治疗组，差异具有统计学意义（分别为治愈率 Z=4.52，P=0.000；有效率 Z=7.71，P=0.000），且副反应中MECT联合治疗组中近事记忆障碍的发生率要高于SSRI药物治疗组（P=0.013），其余的副反应发生率比较均无统计学意义（P >0.05）。结论：与单独 SSRI 药物治疗相比，MECT联合 SSRI 治疗可明显提高难治性抑郁症患者的有效率和治愈率，具有临床指导意义。

Abstract:

Objective：To access the efficacy and safety of MECT plus SSRI in the treatment of refractory depression. Methods：Random－ized controlled trials（RCTs） in relevant databases：Cochrane Library，Pubmed，Web of Knowledge，Ebsco，Chinese Biomedical Litera－ture，China National Knowledge Internet，Wanfang Data and VIP from 1900 to April 2013 were searched. Quality of the literature in－cluded was evaluated and data was extracted. Review Manager 5.0 software was used for Meta analysis. Results：Seven RCTs of 461 patients were included in our study，230 patients in MECT plus SSRI group and 231 patients in SSRI group. Meta analysis results indicated that effective rate and curative rate of MECT plus SSRI group are better than those of SSRI group，with statistically differences（curative rate：Z=4.52，P=0.000；effective rate：Z=7.71，P=0.000）. In addition，incidence of recent memory disorders in MECT plus SSRI group was higher than that of SSRI group（P=0.013）. There was no difference in the rest of side effects between two groups（P >0.05）. Conclusion：MECT plus SSRI is an effective and safety method in the treatment of refractory depression.