阿立哌唑与利培酮治疗儿童精神分裂症的系统评价

目的 系统评价阿立哌唑与利培酮治疗儿童精神分裂症的疗效与安全性，以期为临床治疗提供循证参考。方法 计算机检索PubMed、Cochrane Library、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普数据库（VIP）和万方数据库，收集阿立哌唑对比利培酮治疗儿童精神分裂症的随机对照试验（RCT），检索时限均为建库至2017年7月。根据纳入与排除标准选择文献、提取数据并对最终纳入的研究进行文献方法学质量评价，采用Cochrane协作网推荐的RevMan 5.0软件对各效应指标进行Meta-分析。结果 共纳入7个RCT，计390例患者。Meta-分析结果显示，阿立哌唑组与利培酮组临床显效率P=0.74，OR=1.08，95% CI（0.70，1.66）]与治疗末阴性症状评分P=0.82，MD=-0.13，95% CI（-1.26，1.00）]两方面差异均无统计学意义。利培酮治疗组锥体外系反应（P<0.001）、体质量增加（P<0.001）及月经不调（P=0.000 9）的发生率显著高于阿立哌唑组，差异有统计学意义（P<0.05）。结论 阿立哌唑治疗儿童精神分裂症的疗效与利培酮相当，但锥体外系反应、体质量增加及月经不调的发生率较利培酮低。受纳入文献的质量和样本量限制，上述结论尚待开展更多大样本、高质量的研究予以进一步证实。

Systematic review of efficacy and safety of Aripiprazole and Risperidone in treatment of childhood schizophrenia

Objective To systematically review the efficacy and safety of Aripiprazole versus risperidone in the treatment of childhood schizophrenia, provide evidence-based reference for clinical treatment. Methods Retrieved form pubmed, Cochrane Library, CBM, CNKI, VIP and WanFang date form inception to July 2017 to collect randomized controlled trials (RCT).After quality evaluation and data extract,Meta-analysis was performed by using Rev Man 5.0 statistics software. Results A total of 7 RCT involving 390 patients were included. The results of meta-analysis showed that there was no significant difference difference in the significant efficacyP=0.74, OR=1.08, 95% CI(0.70, 1.66)], negative symptom scoreP=0.82, MD=-0.13, 95% CI(-1.26, 1.00)].the incidences of adverse reaction of extrapyramidal (P<0.001), the incidences of gain weight (P<0.001), the incidences of irregular menstruation (P<0.001) in test group were significantly lower than control group, there were sigaificant differences in 2 groups. Conclusions The efficacy of Aripiprazole and risperidone is similar in the treatment of childhood schizophrenia, however, the safety of Aripiprazole is better than risperidone. limit of methodological quality and sample size, it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.