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目的:评价新型抗精神病药奥氮平和氟哌啶醇治疗谵妄的对比研究。方法:计算机检索Cochrane图书馆、Cochrane临床对照试验资料资料库、Pubmed、中国知网全文数据库、万方数据库2000年1月-2014年10月有关奥氮平和氟哌啶醇治疗谵妄的随机对照试验,并进行Meta分析。结果:共纳入4篇关于两种药物治疗谵妄的随机对照试验和1篇前瞻性非随机对照研究。Meta分析显示奥氮平对谵妄患者简易精神状态评价量表(MMSE)评分的改善优于氟哌啶醇,而对谵妄评定量表(DRS)评分和临床整体印象量表严重程度评分(CGI-SI)的改善与氟哌啶醇组无统计学差异。在副反应研究中,奥氮平的其他神经系统副反应少于氟哌啶醇,而消化系统和锥体外系副反应明显少于氟哌啶醇。结论:奥氮平治疗谵妄的疗效基本与氟哌啶醇相似,但安全性优于氟哌啶醇。由于本Meta分析存在一定方法学的局限性,我们需要更多的含有良好设计方法、样本量足够的多中心、大规模的临床试验来验证本研究结果的可靠性。
OBJECTIVE: To evaluate the comparative study of olanzapine and haloperidol in the treatment of delirium of new antipsychotics. Methods: The Cochrane Library, Cochrane Central Register of Controlled Trials Database, Pubmed, CNKI Full Text Database, Wanfang Database from January 2000 to October 2014 were randomized controlled trials comparing olanzapine with haloperidol in the treatment of delirium , And Meta-analysis. RESULTS: Four randomized controlled trials of two drug-treated delirium and one prospective, non-randomized controlled trial were enrolled. Meta-analysis showed that olanzapine was superior to haloperidol in improving MMSE score in patients with delirium, and the scores of delirium rating scale (DRS) and clinical overall impression scale (CGI- SI) improved with the haloperidol group no significant difference. Side effects in the study, olanzapine other neurological side effects than haloperidol, and digestive and extrapyramidal side effects were significantly less than haloperidol. Conclusion: The efficacy of olanzapine in the treatment of delirium is similar to that of haloperidol, but the safety is better than that of haloperidol. Due to some methodological limitations of this Meta-analysis, we need more multicenter, large-scale clinical trials with good design methods and adequate sample sizes to verify the reliability of our results.