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催产素治疗自闭症谱系障碍儿童核心症状的系统评价和荟萃分析。

Oxytocin treatment for core symptoms in children with autism spectrum disorder: a systematic review and meta-analysis.

机构信息

Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310051, China.

School of Public Health, Shanghai Medical College, Fudan University, Shanghai, 200433, China.

出版信息

Eur J Clin Pharmacol. 2023 Oct;79(10):1357-1363. doi: 10.1007/s00228-023-03545-w. Epub 2023 Aug 4.

Abstract

PURPOSE

The purpose of this article is to examine the efficacy of oxytocin in treating core symptoms of autism spectrum disorder (ASD) with children.

METHODS

A systematic literature search was conducted to identify randomized controlled trials (RCTs) of oxytocin for the treatment of core symptoms in children with ASD. The search included studies published between January 1, 1999 and March 15, 2023, that were randomized, single or double-blinded, and included a placebo control group. Standard screening rules were applied to select relevant studies, resulting in the inclusion of five RCTs involving 486 children with ASD.

RESULTS

Ultimately, a total of five RCTs, involving 486 children with ASD, were included in the review using standard screening rules.One of the included studies demonstrated a statistically significant improvement in Social Responsiveness Scale (SRS) and Repetitive Behavior Scale-Revised (RBS) scores when children with ASD were treated with oxytocin (24 IU/2 days for 6 weeks). The improvement in core symptoms persisted at the 6-month follow-up. The meta-analysis findings suggested that oxytocin might have a moderate effect in improving the core symptom of narrow interests and repetitive stereotyped behaviors in children with ASD.

CONCLUSION

While the therapeutic value of oxytocin in treating core symptoms of ASD in children is not fully established, the results of this meta-analysis indicate a potential moderate effect. However, further studies with larger sample sizes and more robust RCTs are needed to directly demonstrate the efficacy of oxytocin. Future research should also focus on effect size and outcome evaluation accuracy while minimizing bias in RCT experiments.

摘要

目的

本文旨在探讨催产素治疗儿童自闭症谱系障碍(ASD)核心症状的疗效。

方法

系统检索了催产素治疗 ASD 儿童核心症状的随机对照试验(RCT)。检索时间为 1999 年 1 月 1 日至 2023 年 3 月 15 日,包括随机、单盲或双盲、安慰剂对照的研究。采用标准筛选规则选择相关研究,最终纳入 5 项 RCT,共纳入 486 例 ASD 儿童。

结果

最终,采用标准筛选规则,共纳入 5 项 RCT,共纳入 486 例 ASD 儿童。其中 1 项研究表明,催产素治疗 ASD 儿童时,社会反应量表(SRS)和重复行为量表修订版(RBS)评分有统计学意义的改善(24 IU/2 天,持续 6 周)。核心症状改善在 6 个月随访时仍持续。Meta 分析结果表明,催产素可能对改善 ASD 儿童的狭隘兴趣和重复刻板行为的核心症状有中等疗效。

结论

虽然催产素治疗儿童 ASD 核心症状的治疗价值尚未完全确定,但本荟萃分析结果表明其可能有中等疗效。然而,需要更大样本量和更严格 RCT 的研究来直接证明催产素的疗效。未来的研究还应关注效应量和结局评估的准确性,同时最大限度地减少 RCT 试验中的偏倚。

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