CAJ | 학술논문

目的：系统评价在围绝经及绝经后期抑郁妇女中，不同治疗方案疗效的差异，以期指导临床工作。方法通过检索多项在线数据库，系统搜集相关文献，纳入符合标准的随机对照试验（RC T ）及队列研究，并对其进行质量评价和数据提取，完成M eta分析。结果共纳入文献19篇（共2312例），其中RC T 10篇，队列研究9篇。M eta分析结果显示：激素联合抗抑郁药与抗抑郁药比较，治愈率差异无统计学意义（RR＝1．15，P＝0．07），有效率差异有统计学意义（RR＝1．17，P＝0．005）；激素联合抗抑郁药与激素补充治疗比较，治愈率（RR＝1．73，P＝0．003）及有效率（RR＝1．52，P＜0．01）差异均有统计学意义；抗抑郁药与激素补充治疗的有效率比较，差异有统计学意义（RR＝1．37，P＝0．003）；激素补充治疗与安慰剂比较，治愈率差异有统计学意义（RR＝2．17，P＝0．03），有效率差异无统计学意义（RR＝0．78，P＝0．15）。结论虽然激素补充治疗对情绪有改善作用，但对提高围绝经及绝经后抑郁妇女对抗抑郁药反应的作用并不确定。
목적：계통평개재위절경급절경후기억욱부녀중，불동치료방안료효적차이，이기지도림상공작。방법통과검색다항재선수거고，계통수집상관문헌，납입부합표준적수궤대조시험（RC T ）급대렬연구，병대기진행질량평개화수거제취，완성M eta분석。결과공납입문헌19편（공2312례），기중RC T 10편，대렬연구9편。M eta분석결과현시：격소연합항억욱약여항억욱약비교，치유솔차이무통계학의의（RR＝1．15，P＝0．07），유효솔차이유통계학의의（RR＝1．17，P＝0．005）；격소연합항억욱약여격소보충치료비교，치유솔（RR＝1．73，P＝0．003）급유효솔（RR＝1．52，P＜0．01）차이균유통계학의의；항억욱약여격소보충치료적유효솔비교，차이유통계학의의（RR＝1．37，P＝0．003）；격소보충치료여안위제비교，치유솔차이유통계학의의（RR＝2．17，P＝0．03），유효솔차이무통계학의의（RR＝0．78，P＝0．15）。결론수연격소보충치료대정서유개선작용，단대제고위절경급절경후억욱부녀대항억욱약반응적작용병불학정。
Objective To assess the curative effect of different therapeutic regimen in perimenopausal and postmenopausal pa-tients with depressive disorder ,in order to guide clinical work .Methods Relevant literatures were collect by retrieving a number of online database ,,screen documents independent ,the randomized controlled trial(RCT) and cohort study were included ,and carried on the quality evaluation and data extractione ,then completed the Meta analysis .Results 19 papers were inclouded (2 312 cases) , including 10 RCT papers and 9 cohort papers .There was no statistically significant difference for cure rate (RR=1 .15 ,P=0 .07) , the difference of effective rate had statistically significant (RR=1 .17 ,P=0 .005) .Hormone in combination with antidepressants compared with hormone replacement therapy :the difference of cure ratio (RR=1 .73 ,P=0 .003) and effective rate (RR=1 .52 , P<0 .01) all had statistically significant .The difference of effective rate between antidepressants and hormone replacement therapy had statistically significant (RR=1 .37 ,P=0 .003) .Hormone replacement therapy compared with placebo :the difference of cure rate had statistically significant(RR=2 .17 ,P=0 .03) ,the difference of effective rate had no statistically significant (RR= 0 .78 ,P=0 .15) .Conclusion Although the hormone replacement therapy has a positive effect on the mood ,it′s promoting effect on the anti-depressant of perimenopausal and postmenopausal women is uncertain .