【摘要】 目的 系统性评价抗抑郁药物治疗产后抑郁(PPD)的有效性和可接受性。方法 检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据库、维普中文数据库、中国生物医学文献服务系统(SinoMed)数据库，截止时间为2023年11月。筛选抗抑郁药物治疗PPD的随机对照试验(RCT),试验组给予抗抑郁药物，对照组给予安慰剂或另一种抗抑郁药物处置，用Stata 17.0软件对有效性和可接受性进行Meta分析。结果 本研究共纳入27项RCT,共计2 202例患者。Meta分析结果显示：与安慰剂有效性相比，排名前3的是米氮平[比值比(OR)=2.25,95%置信区间(95%CI)=1.20～3.30,P<0.05]、去甲替林(OR=1.50,95%CI=0.55～2.44,P>0.05)、文拉法辛(OR=1.35,95%CI=0.13～2.56,P>0.05);与安慰剂可接受性相比，排名前3的是中草药(OR=0.47,95%CI=-0.72～1.66,P>0.05)、去甲替林(OR=-0.08,95%CI=-1.16～1.33,P>0.05)、文拉法辛(OR=-0.12,95%CI=-1.47～1.24,P>0.05)。结论 去甲替林、文拉法辛、曲唑酮和度洛西汀治疗PPD的有效性良好，且无明显药物不良反应。更多还原

【Abstract】 Objective To systematically evaluate the effectiveness and acceptability of antidepressant drugs in the treatment of postpartum depression(PPD).Methods The PubMed,Cochrane Library,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Journals of Chinese Scienc were searched,and Chinese Biomedical Literature Service System(SinoMed) database until November 2023.Screen randomized controlled trials(RCTs) of antidepressant drugs for the treatment of PPD.The treatment group was given antidepressant drugs,and the control group was given placebo or another antidepressant drug.Meta-analysis of effectiveness and acceptability is performed using Stata 17.0 software.Results A total of27 RCTs with a total of 2 202 patients were included.The results of meta-analysis showed:The top three efficacy relative to placebo were mirtazapine [odds ratio(OR)=2.25,95% confidence interval(CI)=(1.20-3.30),P <0.05],nortriptyline [OR=1.50,95% CI=(0.55-2.44),P> 0.05],venlafaxine [OR=1.35,95% CI=(0.13-2.56),P>0.05].Acceptability is compared with placebo in the top three Chinese herbal medicine [OR=0.47,95% CI=(-0.72-1.66),P>0.05],nortriptyline [OR=-0.08,95% CI=(-1.16-1.33),P> 0.05],venlafaxine [OR=-0.12,95%CI=(-1.47-1.24),P> 0.05].Conclusion Nortriptyline,venlafaxine,trazodone,and duloxetine are effective in treating PPD without obvious adverse drug reactions.更多还原