Abstract: Objective To assess the efficacy and safety of Topiramate and Haloperidol in the treatment of children with tic disorder. Methods The randomized controlled trials about children with tic disorder treated with Topiramate and Haloperidol published before January 2014,were searched in the PubMed,EBSCO,EMbase,Ovid,Cochrane Library,CNKI,Wanfang Date and VIP.Some published references were hand-searched.Two reviewers independently screened the literatures,extracted the data and evaluated quality.Meta analysis was conducted by Revman 5.1 and Stata 12.0 software. Results Sixteen RCTs involving 1 148 patients [treatment group (n=609);control group (n=539)] were included.Ages were 2.5 to 17 years old.Meta-analysis of motor tic scores,vocal tic scores,comprehensive damage scores and severity scores indicated the treatment group was superior to the control group [Mean difference (Inverse Variance,Random) -13.58 to -4.58 (95%CI:-22.44~-1.32)].Meta-analysis of the number of tic symptom improvement showed the treatment group was superior to the control group (OR=1.71,95%CI:1.22~2.39).Meta-analysis of the number of adverse events showed the treatment group was superior to the control group(OR=0.42,95%CI:0.24~0.75). Conclusion Topiramate has more advantage than haloperidol in the efficacy and safety for children with tic disorder,especially Tourette syndrome.

Key words: Topiramate, Haloperidol, children, tic disorder, Meta-analysis

摘要： 目的 比较托吡酯与氟哌啶醇治疗儿童抽动障碍的疗效及安全性,为临床治疗提供参考依据。方法 计算机检索PubMed、EBSCO、EMbase、Ovid、Cochrane Library、中国期刊全文数据库、万方数据库和维普中文科技期刊数据库,纳入关于托吡酯与氟哌啶醇治疗儿童抽动障碍的随机对照研究,检索时限从建库起至2014年1月,手工检索相关的已发表文献。由两位研究者独立进行文献筛检、资料提取和方法学质量评价后,采用Revman5.1和Stata12.0软件进行Meta分析。结果 最终纳入16篇RCTs,共1 148例患者(治疗组609例;对照组539例),年龄2.5~17岁。Meta分析结果显示,两组抽动症状改善的总例数差异有统计学意义[OR=1.71,(95%CI:1.22~2.39)];两组运动性抽动分数、发声性抽动分数、综合损害分数和严重度总分差异均有统计学意义[MD -13.58~-4.58(95%CI:-22.44~-1.32),P均<0.01];两组不良反应发生总例数差异有统计学意义[OR=0.42,(95%CI:0.24~0.75)]。结论 托吡酯用于治疗儿童抽动障碍尤其是抽动秽语综合症,其疗效及安全性均优于氟哌啶醇。

关键词: 托吡酯, 氟哌啶醇, 儿童, 抽动障碍, Meta分析