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哌醋甲酯和托莫西汀治疗注意缺陷多动障碍的有效性和安全性:系统评价。

Effectiveness and safety of methylphenidate and atomoxetine for attention deficit hyperactivity disorder: a systematic review.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.

出版信息

Transl Pediatr. 2012 Jul;1(1):47-53. doi: 10.3978/j.issn.2224-4336.2012.04.04.

Abstract

OBJECTIVE

To assess and compare the effectiveness and safety of methylphenidate immediate-release tablets (IR-MPH), methylphenidate controlled-release tablets (OROS-MPH) and atomoxetine (AHC) for attention deficit hyperactivity disorder (ADHD) in Chinese children.

METHODS

Randomized or clinical controlled trials on the effectiveness and safety of IR-MPH, OROS-MPH and AHC for ADHD were searched in electronic databases of CNKI, VIP, CBMDISC online, PubMed, Embase and MEDLINE. Two reviewers independently extracted the data and assessed the quality of the included literatures.

RESULTS

Eight trials were finally included. IR-MPH, OROS-MPH and AHC were effective for ADHD. OROS-MPH was superior to IR-MPH in the improvement of peer relationship, CGI-I score, mother satisfaction and psychosomatic problems. There were no significant differences in the effectiveness between the AHC and IR-MPH groups. The adverse events related to the therapy with IR-MPH, OROS-MPH or AHC were mild and total incidence rates of adverse events was not significantly different among the three groups.

CONCLUSIONS

The effectiveness of OROS-MPH for the treatment of ADHD is probably superior to IR-MPH, and the effectiveness of AHC and IR-MPH is similar. The three drugs have equivalent safety and good tolerance.

摘要

目的

评估和比较哌醋甲酯速释片(IR-MPH)、哌醋甲酯控释片(OROS-MPH)和托莫西汀(AHC)治疗中国儿童注意缺陷多动障碍(ADHD)的疗效和安全性。

方法

在 CNKI、VIP、CBMDISC 在线、PubMed、Embase 和 MEDLINE 电子数据库中检索关于 IR-MPH、OROS-MPH 和 AHC 治疗 ADHD 的疗效和安全性的随机或临床对照试验。两位评审员独立提取数据并评估纳入文献的质量。

结果

最终纳入 8 项试验。IR-MPH、OROS-MPH 和 AHC 对 ADHD 均有效。OROS-MPH 在改善同伴关系、CGI-I 评分、母亲满意度和身心问题方面优于 IR-MPH。AHC 组和 IR-MPH 组的疗效无显著差异。与 IR-MPH、OROS-MPH 或 AHC 治疗相关的不良事件较轻,三组不良事件总发生率无显著差异。

结论

OROS-MPH 治疗 ADHD 的疗效可能优于 IR-MPH,AHC 和 IR-MPH 的疗效相似。三种药物具有相当的安全性和良好的耐受性。

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