UNASSIGNED:系统评估暴露和反应预防(ERP)联合药物治疗强迫症(OCD)的有效性。
未经授权:PubMed,WebofScience,EBSCO,科克伦,Embase,搜索和ScienceDirect数据库,包括符合标准的ERP与强迫症药物联合治疗的随机对照试验.耶鲁布朗强迫症量表被用作主要结果指标,抑郁量表作为次要结局指标。对偏倚风险进行评估,以根据方法学和临床因素确定可能的偏倚来源。使用ReviewManager5.3和Stata16.0软件对提取的数据进行荟萃分析。
UNASSIGNED:共纳入21项研究,共1113例患者。Meta分析显示,ERP联合药物治疗明显优于单纯药物治疗,包括选择性5-羟色胺再摄取抑制剂,氯米帕明和利培酮(MD=-6.60,95%CI:-8.35至-4.84,P<0.00001),但D-环丝氨酸(DCS)药物对OCD患者的ERP干预效果没有增强(MD=0.15,95%CI:-0.87至1.17,P=0.77)。在随访期间,药物加ERP的联合治疗方法比单独药物治疗更明显(MD=-7.14,95%CI:-9.17至-5.10,P<0.00001)。DCS药物未增强ERP干预对OCD患者抑郁的影响(SMD=-0.08,95%CI:-0.31至0.15,P=0.50)。ERP联合药物改善患者的抑郁水平明显优于单独提供药物(SMD=-0.40,95%CI:-0.68至-0.11,P=0.006)。
UNASSIGNED:强迫症患者在ERP与药物合用时,强迫症和抑郁症的症状有显著改善,然而,不足以证明DCS可以提高ERP的有效性。
UNASSIGNED: To systematically evaluate the effectiveness of exposure and response prevention (ERP) combined with medication on obsessive-compulsive disorder (OCD).
UNASSIGNED: PubMed, Web of Science, EBSCO, Cochrane, Embase, and Science Direct databases were searched to include randomized controlled trials of ERP combined with medication for OCD that met the criteria. The Yale Brown Obsessive Compulsive Scale was used as the primary outcome indicator, and Depression scales were used as secondary outcome indicators. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors.
Review Manager 5.3 and Stata 16.0 software was used to perform meta-analysis of the extracted data.
UNASSIGNED: A total of 21 studies with 1113 patients were included. Meta-analysis showed that ERP combined with medication therapy was significantly better than medication therapy alone including selective serotonin reuptake inhibitors, clomipramine and risperidone (MD = -6.60, 95% CI: -8.35 to -4.84, P < 0.00001), but D-cycloserine (DCS) drugs do not enhance the effect of ERP intervention in patients with OCD (MD = 0.15, 95% CI: -0.87 to 1.17, P = 0.77). There is more significant maintenance by combined treatment method of medication plus ERP than medication treatment alone during the follow-up period (MD = -7.14, 95% CI: -9.17 to -5.10, P < 0.00001). DCS drugs did not enhance the effect of ERP intervention on depression in patients with OCD (SMD = -0.08, 95% CI: -0.31 to 0.15, P = 0.50). ERP combined with drug improved patients\' depression levels significantly better than providing drug alone (SMD = -0.40, 95% CI: -0.68 to -0.11, P = 0.006).
UNASSIGNED: Patients with OCD have significant improvement in symptoms of obsessive-compulsive disorder and depression when ERP is combined with medication, however, not enough to prove that DCS can enhance ERP effectiveness.