上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

高频左侧经颅磁刺激作为电休克抑郁症替代疗法的meta分析

王 鑫1，周宏志2，欧可可1   

  1. 1.四川省司法警官总医院神经内科， 成都 610225； 2.四川大学华西医院神经内科， 成都 610041
  • 出版日期:2014-08-28 发布日期:2014-09-02
  • 通讯作者: 欧可可, 电子信箱: oukeke123@126.com。
  • 作者简介:王 鑫(1984—)， 男， 住院医师， 学士; 电子信箱: wxign163@163.com。

High frequency left-side repetitive transcranial magnetic stimulation for replacing treatment of depression by electroconvulsive therapy: a meta analysis

WANG Xin1, ZHOU Hong-zhi2, OU Ke-ke1   

  1. 1.Department of Neurology, Sichuan Judicial Police General Hospital, Chengdu 610225, China; 2.Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Online:2014-08-28 Published:2014-09-02

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摘要：

目的 系统评价高频左侧重复经颅磁刺激(HFL-rTMS)能否替代电休克(ECT)治疗抑郁症患者。方法 计算机检索PubMed、Cochrane图书馆、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP)、Web of Science和Embase等数据库中关于HFL-rTMS与ECT治疗抑郁症的随机对照研究(RCT)，截止时间设定为2013年8月。两名研究者根据纳入和排除标准独立筛选文献和提取数据，评价指标包括有效率、缓解率和失访率。结果 共有8篇高质量的RCT纳入meta分析。8篇RCT的分析结果显示HFL-rTMS与ECT治疗抑郁症的有效率相当(OR=0.83，95%CI：0.53～1.30，P=0.420)；6篇RCT的分析结果显示HFL-rTMS与ECT治疗抑郁症的缓解率相当(OR=0.64, 95%CI：0.36～1.13，P=0.120)；3篇RCT的分析结果显示HFL-rTMS与ECT治疗抑郁症的失访率相当(OR=0.39, 95%CI：0.14～1.11，P=0.080)。各项meta分析中不存在显著的异质性和发表偏倚。结论 HFL-rTMS作为ECT治疗抑郁症的替代疗法具有潜在的可行性。

关键词: 重复经颅磁刺激, 电休克, 抑郁症, meta分析

Abstract:

Objective To systematically evaluate whether high frequency left-side repetitive transcranial magnetic stimulation (HFL-rTMS) can replace electroconvulsive therapy (ECT) for treating patients with depression. Methods Randomized controlled trials (RCTs) that were relevant to treating depression by HFL-rTMS and ECT and published before August 2013 were retrieved from PubMed, CCTR, Web of Science, Embase, CECDB, CQVIP, CBM, and CNKI. Two researchers independently screened studies and abstracted data according to the inclusion/exclusion criteria. Evaluation indexes included the response rate, remission rate, and drop-out rate. Results Meta analysis was conducted for 8 high quality RCTs. The results of analysis of 8 RCTs showed that the response rate of HFL-rTMS for treating the depression was equivalent to that of ECT (OR=0.83, 95%CI: 0.53～1.30, P=0.420). The results of analysis of 6 RCTs showed that the remission rate of HFL-rTMS was equivalent to that of ECT (OR=0.64, 95%CI: 0.36～1.13, P=0.120). The results of analysis of 3 RCTs showed that the drop-out rate of HFL-rTMS was equivalent to that of ECT (OR=0.39, 95%CI: 0.14～1.11, P=0.080). No significant heterogeneity and publication bias existed in meta analyses. Conclusion HFL-rTMS is a potential method for replacing the treatment of depression by ECT.

Key words: repetitive transcranial magnetic stimulation, electroconvulsive therapy, depression, meta analysis