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氯胺酮治疗难治性抑郁症有效性和安全性的Meta分析

Effectiveness and safety of ketamine for treatment-resistant depression: a meta-analysis

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【作者】 丛安安刘畅康利锐袁晶晶栾树鑫

【Author】 CONG An-an;LIU Chang;KANG Li-rui;YUAN Jing-jing;LUAN Shu-xin;the First Hospital of Jilin University;

【通讯作者】 栾树鑫;

【机构】 吉林大学第一医院心理卫生科吉林大学第一医院心血管内科

【摘要】 目的:系统评价氯胺酮治疗难治性抑郁症(TRD)的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMBase等数据库,搜索有关氯胺酮(试验组)与安慰剂(对照组)治疗TRD的随机对照研究(RCT)。结果:最终纳入13项RCT。Meta分析结果显示:试验组治疗后1个月内蒙哥马利抑郁评定量表(MADRS)、汉密尔顿抑郁量表(HAMD)、临床总体印象量表(CGI-S)、临床总体印象改善量表(CGI-I)评分改善优于对照组(P均<0.05)。在治疗后1周至1个月内,试验组总体印象严重度量表(PGI-S)、总体印象变化量表(PGI-C)评分改善比对照组有优势(P均<0.05);1 d至1周内,试验组自我描述量表(SDQ)评分改善优于对照组(P<0.05),28 d时试验组抑郁自评量表(SDS)、抑郁筛查量表(PHQ)评分改善优于对照组(P均<0.05)。试验组临床有效率高于对照组(P<0.05)。试验组比对照组更容易发生恶心、呕吐、头晕、疲劳、分离状态、血压升高、视物模糊等不良反应。结论:氯胺酮治疗TRD有显著疗效,但应注意其不良反应的发生。

【Abstract】 Objective: To systematically review the effectiveness and safety of ketamine for treatment-resistant deression(TRD). Method:Randomized controlled trials(RCTs) of ketamine(trial group) and placebo(control group) in treating TRD were searched from Cochrane Library, PubMed, EMBase and other databases. Results:13 RCTs were included.Meta-analysis showed that the scores of Montgomery Depression Rating Scale(MADRS),Hamilton Depression Rating Scale(HAMD),Clinical Global Impression Scale(CGI-S) and Clinical Global Impression Improvement Scale(CGI-I) in the trial group were better than those in the control group within 1 month after treatment(all P<0.05).After1 week to 1 months of treatment, the scores of Patient Global Impression of Severity(PGI-S),the Patient Global Impression of Change(PGI-C) in the trial group improved better than those in the control group(all P<0.05); after 1 day to 1 weeks of treatment, Self-Description Questionnaire(SDQ) score improvement was better than that of control group(P<0.05);Self-Rating Depression Scale(SDS) and Patient Health Questionaire(PHQ) scores at 28 days improved better than those of control group(both P<0.05).The clinical effective rate of the trial group was higher than that of the control group(P<0.05).Compared with the control group, nausea, vomiting, dizziness, fatigue, disassociation, elevated blood pressure and blurred vision were more likely to be experienced in the trial group. Conclusion:Ketamine has a significant effect on TRD,but attention should be paid to the occurrence of adverse reactions.

  • 【文献出处】 临床精神医学杂志 ,Journal of Clinical Psychiatry , 编辑部邮箱 ,2021年03期
  • 【分类号】R749.4
  • 【被引频次】1
  • 【下载频次】173
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