摘要

目的：系统评价无抽搐电休克( Modified electroconvulsive therapy，MECT)治疗抑郁症患者的疗效和安全性。

方法：计算机检索 PubMed、Web of Science、The Cochrane Library、Embase、WanFang Data 和 CNKI 数据库，搜集MECT对抑郁症患者疗效的RCT试验，检索时限均从建库至 2022 年 11 月，对检索文献进行筛选，依据纳入和排除标准确定最终纳入文献，并对所纳入文献进行质量评价和数据提取，用RevMan 5.3软件对纳入研究进行Meta分析。

结果：对纳入的9项RCT研究使用随机效应模型进行Meta分析的

结果显示，MECT可以显著改善患者的抑郁症状且具有较低异质性[SMD=-0.88，95%CI (-1.09,-0.67),I2=49%,P<0.01]，MECT治疗后患者的副反应不显著且具有低异质性[SMD=0.19，95%CI(-0.01,0.4),I2=0.P>0.05]。亚组分析的

结果显示，治疗次数在8次及以上、治疗时双颞叶放置改变患者抑郁症状的效果相对更好。

结论：MECT治疗抑郁症有显著疗效且未增加副反应，安排8次及以上足疗程、双颞叶放置治疗的效果更佳，这一

结论的发现具有临床指导意义。

关键词：无抽搐电休克;抑郁症;meta分析

ABSTRACT

Objective: To systematically evaluate the efficacy and safety of Modified electroconvulsive therapy (MECT) for depressed patients.

Methods: A computerized search of PubMed, Web of Science, The Cochrane Library, Embase, WanFang Data and CNKI databases was conducted to collect RCTs on the efficacy of MECT in patients with depression, with the search time frame ranging from database creation to November 2022. The final included literature was identified based on the inclusion and exclusion criteria, and the included literature was evaluated for quality and extracted, and Meta-analysis was performed on the included studies using RevMan 5.3 software.

Results: Meta-analysis of the nine included RCT studies using a random-effects model showed that MECT significantly improved patients' depressive symptoms with low heterogeneity [SMD=-0.88, 95%CI(-1.09,-0.67),I2=49%, P<0.01], and had no significant side effects on patients with low heterogeneity [SMD=0.19, 95% CI (-0.01,0.4),I2=0. P>0.05].The results of the subgroup analysis further showed that the number of treatments at 8 and above and treatment with dual temporal lobe placement comparatively improved the depressive symptoms of the patients.

Conclusion  : MECT has significant efficacy and less side in treating depression, and scheduling 8 and more treatments with dual temporal lobe placement may result in better outcomes, and this finding is clinically instructive.

Key words: Modified electroconvulsive therapy; Depression; Meta-analysis