目的 系統(tǒng)評價阿立哌唑與利培酮治療兒童精神分裂癥的療效與安全性，以期為臨床治療提供循證參考。方法 計算機(jī)檢索PubMed、Cochrane Library、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、中國知網(wǎng)（CNKI）、維普數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫，收集阿立哌唑?qū)Ρ壤嗤委焹和穹至寻Y的隨機(jī)對照試驗（RCT），檢索時限均為建庫至2017年7月。根據(jù)納入與排除標(biāo)準(zhǔn)選擇文獻(xiàn)、提取數(shù)據(jù)并對最終納入的研究進(jìn)行文獻(xiàn)方法學(xué)質(zhì)量評價，采用Cochrane協(xié)作網(wǎng)推薦的RevMan 5.0軟件對各效應(yīng)指標(biāo)進(jìn)行Meta-分析。結(jié)果 共納入7個RCT，計390例患者。Meta-分析結(jié)果顯示，阿立哌唑組與利培酮組臨床顯效率[P=0.74，OR=1.08，95% CI（0.70，1.66）]與治療末陰性癥狀評分[P=0.82，MD=-0.13，95% CI（-1.26，1.00）]兩方面差異均無統(tǒng)計學(xué)意義。利培酮治療組錐體外系反應(yīng)（P<0.001）、體質(zhì)量增加（P<0.001）及月經(jīng)不調(diào)（P=0.000 9）的發(fā)生率顯著高于阿立哌唑組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 阿立哌唑治療兒童精神分裂癥的療效與利培酮相當(dāng)，但錐體外系反應(yīng)、體質(zhì)量增加及月經(jīng)不調(diào)的發(fā)生率較利培酮低。受納入文獻(xiàn)的質(zhì)量和樣本量限制，上述結(jié)論尚待開展更多大樣本、高質(zhì)量的研究予以進(jìn)一步證實。

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 efficacy[P=0.74, OR=1.08, 95% CI(0.70, 1.66)], negative symptom score[P=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.

重慶市社會事業(yè)與民生保障科技創(chuàng)新專項（cstc2015shmszx120073）