目的 系統(tǒng)評價齊拉西酮與阿立哌唑治療成人首發(fā)精神分裂癥療效與安全性差異，為臨床用藥提供參考。方法 計算機檢索Pubmed、Medline、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、中國學術(shù)期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫中齊拉西酮與阿立哌唑?qū)φ罩委煶扇耸装l(fā)精神分裂癥的臨床隨機對照試驗（RCT），從建庫至2019年7月；提取數(shù)據(jù)，用RevMan 5.3軟件對各效應指標進行Meta-分析。結(jié)果 納入11項RCTs，共計965例首發(fā)精神分裂癥患者。Meta-分析結(jié)果顯示：2組陽性癥狀與陰性癥狀量表總評分變化值差異無統(tǒng)計學意義，總有效率差異有統(tǒng)計學意義［RR=1.09，95%CI（1.01，1.17），P<0.05］；2組失眠發(fā)生率［RR=0.44，95%CI（0.23，0.86，P<0.05］、錐體外反應發(fā)生率［RR=2.41，95%CI（1.13，5.17）］比較差異均有統(tǒng)計學意義，其他不良反應發(fā)生率無統(tǒng)計學意義。結(jié)論 齊拉西酮與阿立哌唑?qū)Τ扇耸装l(fā)精神分裂癥患者的陽性與陰性癥狀均有明顯改善，其中齊拉西酮可能有更為明顯臨床效果，但錐體外系反應發(fā)生率也相對較高；在治療過程中，兩組患者均有不同程度的不良反應發(fā)生，但患者均可耐受，未影響繼續(xù)治療。

Objective To systematically review the efficacy and safety of ziprasidone and aripiprazole in the treatment of adult firstepisode schizophrenia, and to provide evidence-based reference for clinical drug use. Methods Clinical randomized controlled trial of ziprasidone and aripiprazole in the treatment of adult first-episode schizophrenia in PubMed, Medline, CBM, CNKI, VIP, and Wanfang Database searched by computer, time limit to July 2019. Extraction and analysis of data according to inclusion and exclusion criteria. Meta-analysis of effect Indexes with RevMan 5.3 Software. Results A total of 965 patients with first-episode schizophrenia were included in 11 items of RCTs. The results of Meta-analysis showed that there was no significant difference in the total score of PANSS between the two groups at the end of treatment, there was significant difference in the total effective rate between the two groups [RR=1.09, 95%CI(1.01, 1.17), P < 0.05]. Security aspects: there was significant difference in the incidence of insomnia [RR=0.44, 95%CI(0.23, 0.86)] and extrapyramidal reaction [RR=2.41, 95%CI(1.13, 5.17)] between the two groups (P < 0.05), there was no significant difference in the incidence of other adverse reactions. Conclusion Ziprasidone and aripiprazole significantly improved the positive and negative symptoms of adult first-episode schizophrenia, among which ziprasidone may have more obvious clinical effect, but the incidence of extrapyramidal reaction was also relatively high. In the course of treatment, the two groups of patients had different degrees of adverse reactions, but the patients were tolerable and did not affect the continued treatment.

R971