Abstract: Objective　To examine the efficacy and safety of adjunctive memantine for patients with schizophrenia receiving antipsychotic treatment.Methods　The randomized，double-blind，placebo-controlled trials（RCT） comparing memantine and placebo for patients with schizophrenia published as of July 9，2017 in Chinese were searched from the databases of CNKI，CBM，Wanfang Data Knowledge Service Platform and those in English were searched from PubMed，EMBase，PsycINFO，Cochrane Library by two researchers separately.And relevant printed RCT published during the same period were searched.RCTs screening，data extraction as well as quality assessment were conducted by the two researchers separately.Clinical efficacy，cognitive function，rate of discontinuation and adverse drug reactions were analyzed using RevMan 5.3 software.Results　Nine RCTs with 512 patients（treatment group：n=259；placebo group：n=253） were included.Meta-analyses of total psychopathology 〔SMD=-0.56，95%CI（-1.01，-0.11），P=0.02〕 and negative symptom score 〔SMD=-0.80，95%CI（-1.24，-0.36），P=0.000 4〕 showed the superiority of memantine over placebo，but there was no significant difference between positive symptom score 〔SMD=-0.20，95%CI（-0.48，0.08），P=0.16〕 and general psychopathology scores 〔SMD=-0.27，95%CI（-0.64，0.10），P=0.15〕 of the two groups.Furthermore，meta-analysis of cognitive function assessment showed the superiority of memantine over placebo 〔WMD=3.09，95%CI（1.77，4.42），P<0.000 01〕.Similar rates of discontinuation 〔RR=1.34，95%CI（0.76，2.37），P=0.31〕 and adverse drug reactions were found between the two groups（P>0.05）.Conclusion　This meta-analysis suggests that adjunctive memantine appears to be effective and safe in improving total psychopathology，negative symptom score and neurocognitive function.However，its long-term efficacy and safety are warranted to confirm these findings.

Key words: Memantine, Schizophrenia, Meta-analysis, Treatment outcome, Safety

摘要： 目的　探讨美金刚联合抗精神病药物治疗精神分裂症的效果和安全性。方法　两位研究者分别系统检索中英文数据库（中国期刊全文数据库、中国生物医学文献数据库、万方数据知识服务平台、PubMed、EMBase、PsycINFO、Cochrane Library），检索时间为建库至2017-07-09，纳入关于美金刚联合抗精神病药物治疗精神分裂症的随机对照试验（RCT），并手工检索已发表的相关文献。两位研究者同时独立对纳入文献进行筛检、数据提取和质量评价，采用RevMan 5.3软件对临床疗效、认知功能、脱落率、不良反应发生率进行分析。结果　共纳入9篇RCT，512例患者，其中治疗组259例，对照组253例。Meta分析结果显示，治疗组临床总分〔标准化均数差（SMD）=-0.56，95%CI（-1.01，-0.11），P=0.02〕、阴性症状得分〔SMD=-0.80，95%CI（-1.24，-0.36），P=0.000 4〕均低于对照组；两组阳性症状得分〔SMD=-0.20，95%CI（-0.48，0.08），P=0.16〕及一般精神病理量表得分〔SMD=-0.27，95%CI（-0.64，0.10），P=0.15〕比较，差异均无统计学意义；治疗组认知功能优于对照组〔加权均数差（WMD）=3.09，95%CI（1.77，4.42），P<0.000 01〕；两组脱落率〔优势比（RR）=1.34，95%CI（0.76，2.37），P=0.31〕、不良反应发生率比较，差异均无统计学意义（P>0.05）。结论　美金刚联合抗精神病药物可显著改善精神分裂症患者的临床总分、阴性症状和认知功能，且安全性好，但其远期疗效需进一步探讨。

关键词: 美金刚, 精神分裂症, Meta分析, 治疗结果, 安全性