中文摘要：

目的：通过Meta分析方法,系统评价沃替西汀治疗重度抑郁症（major depressive disorder,MDD）的有效性和安全性。方法：通过检索Pubmed、Clinical trials等数据库,筛选获得沃替西汀治疗MDD的随机对照临床试验（randomized controlled trials,RCTs）,应用Rev Man 5.3软件进行统计分析。结果：与安慰剂相比,5 mg和10mg沃替西汀可显著增加治疗前后的蒙哥马利抑郁评价量表（Montgomery-sberg Depression Rating Scale,MADRS）平均改变量（WMD=-2.59,P=0.002;WMD=-3.47,P=0.000 3）,提高治疗的有效率（OR=1.76,P=0.006;OR=2.18,P=0.005）,增加总体不良反应率（OR=1.28,P=0.008;OR=1.33,P=0.01）,提示沃替西汀的疗效明显优于安慰剂,但不良反应发生率亦增高。与阳性药度洛西汀相比,5 mg沃替西汀治疗后的MADRS平均改变量（P=0.43）和有效率（P=0.10）无统计学差异;但总体不良反应率显著降低（OR=0.52,P〈0.000 1）,提示5 mg沃替西汀的疗效与阳性药物度洛西汀相当,但不良反应发生率明显低于度洛西汀。结论：沃替西汀治疗MDD疗效确切,安全性较好。

英文摘要：

AIM： To systematically review the therapeutic efficacy and safety of vortioxetine in trea- ting major depressive disorder（MDD） with an upda- ted meta-analysis. METHODS： The databases of Pubmed and Clinical trials were searched to obtain the randomized controlled trials （RCTs） of vortioxe- tine in treating MDD. Data were synthesized using RevMan 5.3 software provided by the Cochrane Col- laboration. RESULTS ： Compared with placebo, 5 mg and 10 mg vortioxetine could significantly in- crease the Montgomery-Asberg Depression Rating Scale （MADRS） mean changes （ WMD = - 2.59, P =0.002; WMD= -3.47, P=0.0003）, the responder rate （ OR = 1.76, P = 0. 006 ; OR = 2.18, P = 0. 005 ） and the rate of overall adverse events （OR=1.28, P =0.008; 0R=1.33, P=0.01）, suggesting better effectiveness but higher rate of ad- verse event of vortioxetine. There were no statistical- ly significant differences between vortioxetine （5 rag） and positive drug duloxetine （60 mg ） on MADRS mean changes （ P = 0.43 ） and responder rate （P = 0.10） , while the rate of overall adverse e- vents of 5 mg vortioxetine was much lower （ OR = 0.52, P 〈 0. 000 1 ）. CONCLUSION： Vortioxe- tine is effective and relatively safe for the treatment of MDD.