不同组合治疗双极性障碍躁狂症的有效性:系统性审查和元分析
Peiling Yao1, Pingan Ni1, Liqin Yin1
1Department of Psychosomatic Disorders, Huzhou Third People's Hospital, Huzhou, Zhejiang, China.
Brain and behavior
|December 23, 2025
概括
齐普拉西与情绪稳定剂相结合,在双相躁狂症中与奥兰扎一样有效. 然而,齐普拉西显示出更好的症状改善,更少的副作用,以及增强的神经内分泌标志物.
科学领域:
- 精神病学和行为科学
- 药理学和治疗学 药理学和治疗学
- 神经科学是一个神经科学.
背景情况:
- 双极性障碍是一种严重的精神疾病,其特点是躁狂发作.
- 目前对躁狂的治疗方法通常涉及与抗精神病药物和情绪稳定剂的联合治疗.
- 评估不同抗精神病和情绪稳定剂组合的比较疗效和安全性对于优化患者护理至关重要.
研究的目的:
- 系统地评估ziprasidone与 olanzapine的疗效和安全性,这两种药物与情绪稳定剂相结合,用于治疗双相情感障碍中的躁狂症.
- 提供基于证据的指导,用于双相躁狂症个性化临床治疗策略.
主要方法:
- 在多个数据库 (PubMed,科学网,科克兰图书馆,CNKI,VIP,万芳) 进行系统的文献搜索,截至2025年7月.
- 包括随机对照试验 (RCT) 进行比较ziprasidone或 olanzapine与情绪稳定剂 (碳酸或甲) 结合治疗双极性躁狂.
- 使用RevMan 5.4软件进行的涉及842名患者的10个RCT数据的元分析.
主要成果:
- 齐普拉西和奥兰扎宾联合治疗之间整体临床疗效没有显著差异 (OR = 1.18,p = 0.41).
- 齐普拉西在降低年轻狂热评分表 (YMRS) 评分方面表现出卓越的疗效 (MD = -1.47,p < 0.00001).
- 与齐普拉西一起观察到显著较低的副作用发生率 (OR = 0.16,p < 0.00001) 和BDNF和T3水平的较大增加.
结论:
- 齐普拉西加情绪稳定剂的整体疗效与奥兰扎加情绪稳定剂对双极躁狂的疗效相当.
- 齐普拉西在改善躁狂症状,减少不良事件和增强神经内分泌指标方面具有显著的优势.
- 齐普拉西可能是双相躁狂症的有利替代治疗选择,需要进一步进行高质量,大规模的研究.
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