Rahimi Roja, Nikfar Shekoufeh, Rezaie Ali, Abdollahi Mohammad
Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
World J Gastroenterol. 2009 Apr 7;15(13):1548-53. doi: 10.3748/wjg.15.1548.
We aimed to evaluate the efficacy of tricyclic antidepressants (TCAs) as a therapeutic option for irritable bowel syndrome (IBS) through meta-analysis of randomized controlled trials. For the years 1966 until September 2008, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. Seven randomized, placebo-controlled clinical trials met our criteria and were included in the meta-analysis. TCAs used in the treatment arm of these trials included amitriptyline, imipramine, desipramine, doxepin and trimipramine. The pooled relative risk for clinical improvement with TCA therapy was 1.93 (95% CI: 1.44 to 2.6, P < 0.0001). Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15 (95% CI: -53.27 to -35.04, P < 0.0001). It is concluded that low dose TCAs exhibit clinically and statistically significant control of IBS symptoms.
我们旨在通过对随机对照试验的荟萃分析，评估三环类抗抑郁药（TCA）作为肠易激综合征（IBS）治疗选择的疗效。在1966年至2008年9月期间，检索了PubMed、Scopus、Web of Science和Cochrane对照试验中央注册库，以查找研究TCA治疗IBS疗效的双盲、安慰剂对照试验。七项随机、安慰剂对照临床试验符合我们的标准，并纳入荟萃分析。这些试验治疗组中使用的TCA包括阿米替林、丙咪嗪、地昔帕明、多塞平和曲米帕明。TCA治疗临床改善的合并相对风险为1.93（95%可信区间：1.44至2.6，P<0.0001）。两项研究中，TCA与安慰剂相比，腹痛评分平均变化的效应量为-44.15（95%可信区间：-53.27至-35.04，P<0.0001）。得出的结论是，低剂量TCA对IBS症状具有临床和统计学上的显著控制作用。
