关于附加药物治疗精神分裂症阴性症状有效性的局部研究的系统综述:一项荟萃分析

S. Shafti
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引用次数: 0

摘要

虽然阴性症状与功能低下和生活质量有关,但药物治疗对缺陷综合征的效果并不完美,甚至可能会补贴或加重继发性阴性症状。与此同时,通过附加药物治疗阴性症状导致了不稳定的后果。在目前的试验中,一些本土系统发表的研究已经成为一项新的荟萃分析的主题,以评估辅助精神药物对精神分裂症缺陷综合征的有效性。本研究选取了过去14年间在Razi精神病院进行的12项随机安慰剂对照试验(n=433)进行分析。作为一项共享方案,所有病例都是在男性住院患者中选择的,这些患者在临终关怀慢性科住院,并根据《精神疾病诊断和统计手册,第四版,文本修订版》被诊断为精神分裂症。在这方面,上述样本已进入配对组,双盲评估随机分配精神药物(如抗抑郁药,苯二氮卓类药物,精神兴奋剂,乙酰胆碱酯酶抑制剂)或安慰剂,除了他们目前的药物。在这些试验中,“阴性症状评估量表(SANS)”被用作评估阴性症状的主要结果测量。此外,缓解被定义为SANS评分(总体和/或分量表)严重程度下降bb0 - 20%。虽然本meta分析的异质性为中等,但上述评估的“综合效应大小”显示精神药物对精神分裂症阴性症状的疗效有显著影响(OR =5.40, CI=2.69- 10.85, z= 5.32, p<0.000)。类似的结果也可以在各种阴性症状中找到。在这方面,“快感缺失-社交”表现出最好的“综合效应大小”,其次是“情感钝化”、“逃避-冷漠”、“注意力缺陷”,最后是“哀愁”。所有上述分析的“异质性”不显著,因此是合适的。根据研究结果,精神药物作为附加药物,在改善精神分裂症阴性症状方面具有可评估的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic Review of Local Studies Regarding Efficiency of Add-On Medications on Negative Symptoms of Schizophrenia: A Meta-Analysis
While negative symptoms are connected with poor functioning and quality of life, pharmacological managements have imperfect effects on deficit syndrome and may even subsidize or aggravate secondary negative symptoms. Meanwhile, management of negative symptoms by means of add-on medications has resulted in instable consequences. In the current tryout, some of the indigenous systematic issued studies have been the theme of a new meta-analysis, to assess the effectiveness of adjunctive psychotropic drugs on deficit syndrome of schizophrenia. Twelve randomized placebo-control trials (n=433), which had been implemented in Razi psychiatric hospital in the last 14 years, had been selected for the present analysis. As a shared protocol, all cases had been selected amongst the male inpatients, who were hospitalized in chronic section of the hospice and had been diagnosed schizophrenia in line with “Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision”. In this regard, the aforesaid samples had been entered into matching-group, double-blind assessments for random assignment to a psychotropic medication (like antidepressant, benzodiazepine, psycho-stimulant, Acetyl-cholinesterase inhibitors) or placebo in addition to their current drug. In these trials, “Scale for Assessment of Negative Symptoms (SANS)” had been used as the main outcome measure for evaluation of negative symptoms. Also, response was defined as a decrease in >20% in the severity of SANS score (over-all and/or sub-scales). While the heterogeneity of the present meta-analysis was intermediate, the “Combined Effect Size” of the aforesaid assessments has revealed a significant influence respecting efficiency of psychotropic drugs on negative symptoms of schizophrenia (OR = 5.40, CI=2.69- 10.85, z= 5.32, p<0.000). Similar results, as well, could be found in connection with various negative symptoms. In this regard, ‘Anhedonia-Asociality’ showed the best “Combined Effect Size”, afterwards “Affective Blunting”, “Avolitio -Apathy”, “Attention Deficit”, and last of all “Alogia”. “Heterogeneity” of all said analysis was insignificant and therefore appropriate. According to the findings, psychotropic drugs, as add-on medications, have valuable influence in regard to amelioration of negative symptoms of schizophrenia.
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