背景:在精神分裂症患者中,丹光孟兴汤配合抗精神病药物是其治疗方法之一。然而,关于电光孟星汤与抗精神病药的治疗效果与其他治疗方法之间的差异,信息很少。进行了系统评价,评价了地康孟兴汤等抗精神病药物的疗效和安全性,用于治疗精神分裂症。
方法:我们进行了系统评价(PROSPEROID:CRD42023414603)。这需要从各自的建立日期到2023年4月11日对多个研究数据库进行计算机搜索,该数据库收集了地康孟星汤联合抗精神病药的临床随机对照试验。促成这项研究的数据库是PubMed,WebofScience,Embase,EBSCOhost,科克伦,Scopus,谷歌学者。根据确定的纳入和排除标准筛选每个出版物,并提取了适当的文献并进行了质量评估,使用RevMan5.4进行荟萃分析。
结果:通过对456篇出版物的文献综述,纳入了18项随机对照试验,收集了总共1636例患者的数据。荟萃分析结果显示,与利培酮联合使用,奥氮平,氯丙嗪,氯氮平,齐拉西酮,或阿立哌唑可提高地康孟星汤治疗精神分裂症的总体疗效(P<。00001),其中奥氮平表现出最大的增强作用(Z=3.65,比值比=4.26,95%CI:1.96-9.28,P=.0003).4周/30天治疗(P=.0003)和400mL/d剂量的地康孟兴汤(P=.0004)更有效。此外,阳性和阴性综合征量表(PANSS)总分普遍下降,PANSS阳性症状评分,PANSS阴性症状评分,一般精神病理学评分(全部P<0.05),以及精神分裂症患者的不良反应发生率(Z=2.79,比值比=0.34,95%CI:0.16-0.73,P=0.005)。
结论:药方与不同抗精神病药物合用可改善精神分裂症患者的总体预后;药方与奥氮平合用,剂量为400毫升/天,持续时间为4周/30天,在这方面是最好的,通过减轻症状和减少疾病的副作用。在这项工作的基础上,更多的大样本,多中心,未来高质量的临床研究将有助于进一步验证我们的发现.
BACKGROUND: In patients with schizophrenia, Diankuang Mengxing Decoction with antipsychotics is one of the treatments for it. However, little information is available regarding the difference between the therapeutic effect of Diankuang Mengxing Decoction with antipsychotics and other treatments. Systematic evaluation is conducted to assess the efficacy and safety of Diankuang Mengxing Decoction and other antipsychotics, which are used to treat schizophrenia.
METHODS: We performed a systematic review (PROSPERO ID: CRD42023414603). This entailed a computerized search of several research databases from their respective dates of establishment until April 11, 2023, which collected clinical randomized controlled trials of Diankuang Mengxing Decoction combined with antipsychotics. The databases that contributed to this study were PubMed, Web of Science, Embase, EBSCOhost, Cochrane, Scopus, and Google Scholar. Each publication was screened according to defined inclusion and exclusion criteria, and appropriate literature was extracted and evaluated for quality, for which meta-analysis was performed using RevMan 5.4.
RESULTS: A literature review of 456 publications resulted in the inclusion of 18 randomized controlled trials with data collected from a total of 1636 patients. Meta-analytical results showed combination with risperidone, olanzapine, chlorpromazine, clozapine, ziprasidone, or aripiprazole increased the overall effectiveness of Diankuang Mengxing Decoction when treating schizophrenia (P < . 00001), among whom olanzapine demonstrated the greatest enhancement (Z = 3.65, odds ratio = 4.26, 95% CI: 1.96-9.28, P = .0003). The 4-week/30-day treatment (P = .0003) and a dosage of 400 mL/d of Diankuang Mengxing Decoction (P = .0004) were more effective. Also, there were widespread reductions to the Positive And Negative Syndrome Scale (PANSS) total scores, PANSS-positive symptom scores, PANSS-negative symptom scores, general psychopathology scores (P < .05 for all), as well as the incidence of adverse effects (Z = 2.79, odds ratio = 0.34, 95% CI: 0.16-0.73, P = .005) in patients with schizophrenia.
CONCLUSIONS: The combination of Diankuang Mengxing Decoction with different antipsychotics can improve the overall prognosis of patients with schizophrenia; Diankuang Mengxing Decoction combined olanzapine, a dosage of 400 mL/d and a duration of 4 weeks/30 days being the best in this regard, by alleviating the symptoms and diminishing the disorder\'s adverse effects. To build on this work, more large-sample, multi-center, and high-quality clinical studies in the future would help to further validate our findings.