摘要
目的系统评价θ爆发式磁刺激(theta burst stimulation,TBS)对抑郁症的干预效果。方法系统检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普和中国生物医学文献数据库(China Biology Medicine disc,CBM)中关于TBS治疗抑郁症的随机对照试验(randomized controlled trial,RCT),检索时间为建库至2023年7月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入12项RCTs,共1080例患者,meta分析结果显示:与假TBS刺激相比,TBS组临床应答率[OR=4.21,95%CI为2.50~7.08,P<0.00001]、临床缓解率[OR=2.72,95%CI为1.46~5.10,P=0.002]优于假刺激,两组的不良事件发生率[OR=1.48,95%CI为0.82~2.68,P=0.20]、停用率[OR=1.12,95%CI为0.47~2.66,P=0.79]差异无统计学意义。TBS与标准重复经颅磁刺激(repetitive transcranial magneticstimulation,rTMS)相比,两组的临床应答率[OR=1.19,95%CI为0.89~1.59,P=0.25]、临床缓解率[OR=1.27,95%CI为0.91~1.75,P=0.16]、不良事件发生率[OR=0.89,95%CI为0.64~1.22,P=0.46]、停用率[OR=1.27,95%CI为0.67~2.40,P=0.46]差异均无统计学意义。结论TBS对抑郁症患者的临床应答率、缓解率具有较好的疗效,且安全性良好,但仍需大规模、多中心RCTs证实。
Objective To systematically evaluate the intervention effect of theta burst stimulation(TBS)on depression.Methods A systematic search of PubMed,Cochrane Library,Embase,Web of Science,CNKI,Wanfang,VIP and China Biomedical Database for randomised controlled trials on TBS for patients with depression was performed from the time of library construction to July 2023.After the literature was screened independently by two investigators,the information was extracted and the risk of bias in the included studies was evaluated,meta was performed using RevMan5.3 software.Results A total of 12 RCTs with 1080 patients were included,and the results of meta-analysis showed that compared with sham stimulation,the clinical response in the TBS group[OR=4.21,95%CI:2.50—7.08,P<0.00001],clinical remission[OR=2.72,95%CI:1.46—5.10,P=0.002]was significantly better than that of sham stimulation,and there was no difference in the incidence rate of adverse events[OR=1.48,95%CI:0.82~2.68,P=0.20],discontinuation rate[OR=1.12,95%CI:0.47—2.66,P=0.79],and discontinuation rate between the two groups.The difference was not statistically significant,and clinical response[OR=1.19,95%CI:0.89—1.59,P=0.25],clinical remission[OR=1.27,95%CI:0.91—1.75,P=0.16],and adverse event rate[OR=0.89,95%CI:0.64—1.22,P=0.46],and discontinuation rate[OR=1.27,95%CI:0.67—2.40,P=0.46]were not statistically significant differences.Conclusion TBS has good efficacy in clinical response,remission,and maintenance of remission in depression,and has a good safety profile,but large-scale,multicentre RCTs are still needed to confirm this.
作者
康佳悦
蔡明娜
张丽娟
KANG Jia-yue;CAI Ming-na;ZHANG Li-juan(School of Nursing,Beihua University,Jilin 132013,China;不详)
出处
《慢性病学杂志》
2024年第4期487-493,共7页
Chronic Pathematology Journal
作者简介
康佳悦,硕士研究生在读,研究方向:儿科护理;通信作者:张丽娟,E-mail:1870991771@qq.com
