网络出版日期: 2016-01-13
Therapeutic effect of 5 drugs on Chinese patients with schizophrenia by using network meta-analysis
Online published: 2016-01-13
目的 以网络meta分析方法综合评价阿立哌唑(Ari)、奥氮平(Ola)、帕利哌酮(Pal)、喹硫平(Que)和利培酮(Ris)5 种药物对中国精神分裂症患者的疗效。方法 计算机检索PubMed、Cochorane Library、中国知网(CNKI)、中文科技期刊数据库、中国学术期刊数据库和中国科学引文数据库,按照入选标准纳入文献,并进行质量评价。在WinBUGS 1.4.3软件中构建贝叶斯网络化模型,用药物的OR值来估计推荐的优先级。结果 纳入的60项临床试验共5 280例患者。网络meta分析显示:相比Pal、Ari、Ola和Ris,Que能显著提高临床有效率,OR值(Pal、Que)=0.4154(95%CI:0.2529~0.6367),OR值(Pal、Ris)=0.6744(95%CI:0.5217~0.8555),OR值(Ari、Que)=0.5491(95%CI:0.2988~0.9096),OR值(Ola、Que)=0.4746(95%CI:0.2805~0.7558),OR值(Que、Ris)=1.694(95%CI:1.115~2.495),差异具有统计学意义。结论 由分析结果可知,尽管Que有较高的推荐等级,但由于纳入的研究较少,其药物有效性还需进一步的证据支持。
顾文洁 , 张五芳 , 王超 , 等 . 5种药物在中国精神分裂症人群中的有效性与网络meta分析[J]. 上海交通大学学报(医学版), 2015 , 35(11) : 1666 . DOI: 10.3969/j.issn.1674-8115.2015.11.014
Objective To comprehensively assess the therapeutic effect of 5 antipsychotic drugs, i.e. aripiprazole (Ari), olanzapine (Ole), paliperidone (Pla), quetiapine (Que), and risperidone (Ris), on patients with schizophrenia by using the network meta-analysis. Methods Papers were retrieved from PubMed, Cochorane Library, CNKI, China Science and Technology Journal Database, China Science Periodical Database, and Chinese Science Citation Database according to the predefined inclusion and exclusion criteria and quality assessment was conducted. The Bayesian network model was established by WinBUGS1.4.3 and the priority of recommendation levels was estimated by the OR value of drugs. Results A total of 5280 patients were enrolled in 60 clinical tests. The results of network meta-analysis showed that compared with Pal, Ari, Ola and Ris, Que significantly improved the clinical efficiency. OR (Pal, Que)=0.415 4 (95%CI: 0.252 9-0.636 7), OR (Pal, Ris)=0.674 4 (95%CI: 0.521 7-0.855 5), OR (Ari, Que)=0.5491 (95%CI: 0.298 8-0.909 6), OR (Ola, Que)=0.474 6 (95%CI: 0.280 5-0.755 8), and OR (Que, Ris)=1.694 (95%CI: 1.115-2.495). The differences were statistically significant. Conclusion Based on the results of network meta-analysis, the recommendation level of Que is higher than that of other drugs. But further evidences are needed to verify the therapeutic effect due to lack of studies.
Key words: schizophrenia; bayesian model; network meta-analysis
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