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Adjunctive Peony-Glycyrrhiza decoction for antipsychotic-induced hyperprolactinaemia:a meta-analysis of randomised controlled trials

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General Psychiatry 2018年第4期31卷 3-9页

作者： Wei Zheng Dong-Bin Cai Hai-Yan Li Yu-Jie Wu Chee H Ng Gabor S Ungvari Shan-Shan Xie Zhan-Ming Shi Xiao-Min Zhu Yu-Ping Ning Yu-Tao Xiang Department of Psychiatry The Affliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital)GuangzhouChina Department of Neurology Shenzhen Traditional Chinese Medicine HospitalShenzhenChina Department of Psychiatry University of MelbourneMelbourneAustralia The University of Notre Dame Australia FremantleAustralia Division of Psychiatry Medical SchoolUniversity of Western AustraliaPerthAustralia Department of Psychiatry Mental Health Center of Hebei ProvinceBaodingChina Department of Psychiatry Chongqing Jiangbei Mental Health HospitalChongqingChina Department of Psychiatry Suzhou Psychiatric HospitalThe Affliated Guangji Hospital of Soochow UniversitySuzhouChina Unit of Psychiatry Faculty of Health SciencesUniversity of MacaoMacaoChina

Background hyperprolactinaemia is a common adverse effect of antipsychotics （APs）. The results of Peony-Glycyrrhiza decoction （PGD） as a potentially useful adjunctivetreatment for hyperprolactinaemia are *** This meta-analysis of randomised controlled trials （RCTs） examined the effcacy and safety of adjunctive PGDtherapy for AP-induced *** English （PubMed, Embase, Cochrane Library, PsycINFO） and Chinese （Chinese National Knowledge Infrastructure, Wanfang Data） databases were systematicallysearched up to 10 June 2018. The inclusion criteria were based on PICOS-Participants： adult patients with schizophrenia; Intervention： PGD plus APs; Comparison： APs plus placebo or AP monotherapy; Outcomes： effcacy and safety; Study design： RCTs. The weighted mean difference （WMD） and risk ratio （RR） along with their 95% CIs were calculated using Review Manager （RevMan） V.5.3 *** Five RCTs （n=450） were included and analysed. Two RCTs （n=140） were double-blind and four RCTs （n=409） reported ‘random’ assignment with specifc description. The PGD group showed a signifcantly lower serum prolactin level at endpoint than the control group （n=380, WMD：？32.69 ng/mL （95% CI -41.66 to 23.72）, p〈0.00001, I2=97%）. Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale （n=403, WMD： -0.62 （95% CI -2.38 to 1.15）, p=0.49, I^2=0%）. There were similar rates of all-cause discontinuation （n=330, RR 0.93 （95% CI 0.63 to 1.37）, p=0.71, I^2=0%） and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low’ （14.3%）, ‘low’ （42.8%）, ‘moderate’ （14.3%）, to ‘high’ （28.6%）.Conclusions Current evidence

关键词： Adjunctive Peony-Glycyrrhiza decoction antipsychotic-induced hyperprolactinaemia a meta-analysis of randomised controlled trials

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