中国临床心理学杂志

催产素对孤独症谱系障碍患者的影响:随机对照试验的系统综述和meta分析

作者：闫喜春程怡杨长江

单位：华东师范大学教育学部上海 200062

分类号：R395.2

出版年,卷(期):页码：2018,26(2):327-332

摘要：

目的：综合评价随机对照试验（RCTs）研究中，催产素（OT）对孤独症谱系障碍（ASD）患者的社交功能和刻板行为的影响。方法：检索PubMed，Embase，Cochrane library，PsycINFO和Web of science数据库，并追踪相关参考文献，运用Stata14.0软件进行定量分析。结果：共纳入17篇文献，有关社交功能的16篇文献中，有9篇显示OT有显著促进作用，与刻板行为相关的8篇文献中，只有一项研究发现OT改善了刻板行为。Meta分析结果显示，OT对ASD患者社交功能和刻板行为的合并效应量Hedges’g值分别为0.167（P=0.355）和0.020（P=0.901）。结论：OT对ASD有混合作用，meta分析显示OT对ASD个体的社交功能和刻板行为没有显著影响，鉴于纳入的RCTs研究数量有限，OT对ASD的作用仍需进一步研究。

Objective:To review randomize controlled trials(RCTs) examining the effects of oxytocin(OT) administration on social function and restricted, repetitive behaviors in individuals with ASD. Methods:Literature searches were conduct-ed in PubMed, Embase, Cochrane library, PsycINFO and Web of science, and reference lists from identified articles to re-trieve relevant studies. The results were analyzed using stata14.0 software. Results:17 RCTs were included in this review. 9 out of the 16 studies that examined social function reported improvements. Additionally, one out of the eight studies on re-stricted, repetitive behaviors, reported improvements following OT administration. Meta-analysis showed that the combined effect of OT on social function and restricted, repetitive behaviors was 0.167(P=0.355) and 0.020(P=0.901), respectively. Conclusion:Previous evidence revealed mixed findings about the effects of OT on ASD. Results from our meta-analyses suggest that OT has no significant effect on social function and restricted, repetitive behaviors. Given the limited number of RCTs, our summary of findings on the effectiveness of OT on ASD should still be considered tentative and further studies is still to be need.

基金项目：

国家自然科学基金项目（81501180）资助；华东师范大学研究生“科研创新实践”项目（ykc17047）资助

作者简介：

参考文献：

1 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifthed. (DSM-V). Washington DC:American Psychiatric Association, 2013
2 钱乐琼, 杨娜, 肖晓, 等. 孤独症谱系障碍儿童的早期干预方法综述. 中国临床心理学杂志, 2013, 21(5):856-862
3 徐云, 杨健. 自闭症早期发现研究进展. 中国临床心理学杂志, 2014, 22(6):1023-1027
4 杨昱, 王曼. 学龄前孤独症儿童家庭的职业和经济负担调查. 中国临床心理学杂志, 2014, 22(2):295-361
5 田金来, 王丽英, 张向葵. 公立小学儿童孤独症谱系障碍患病率及其影响因素. 中国临床心理学杂志, 2016, 24(2):277-281
6 Sprung M, Münch HM, Harris PL, et al. Children's emotion understanding:A meta-analysis of training studies. Developmental Review, 2015, 37:41-65
7 Reichow B, Barton E, Boyd B, et al. Early intensive behavioral intervention(EIBI) for young children with autism spectrum disorders(ASD). Cochrane Database of Systematic Reviews, 2012, 10(10):CD009260
8 Howlin P, Udwin O. Outcomes in neurodevelopmental and genetic disorders. MA, USA:Cambridge University Press:Cambridge, 2002
9 Howlin P, Baron-Cohen S, Hadwin J. Teaching children with autism to mind-read. A practical guide for teachers and parents. NY, USA:Wiley:New York, 1999
10 Virues-Ortega J, Julio FM, Pastor-Barriuso R. The TEACCH program for children and adults with autism:A meta-analysis of intervention studies. Clinical Psychology Review, 2013, 33(8):940-953
11 Reichow B. Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 2012, 42(4):512-520
12 Sharma A, Shaw SR. Efficacy of risperidone in managing maladaptive behaviors for children with autistic spectrum disorder:A meta-analysis. Journal of Pediatric Health Care, 2012, 26(4):291-299
13 Centres for Disease Control and Prevention. Prevalence of autism spectrum disorders-Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR, 2012
14 Green L, Fein D, Modahl C, et al. Oxytocin and autistic disorder:Alterations in peptide forms. Biological Psychiatry, 2001, 50(8):609-613
15 Graustella AJ, MacLeod C. A critical review of the influence of oxytocin nasal spray on social cognition in humans:Evidence and future directions. Hormones and Behavior, 2012, 61(3):410-418
16 Meyer-Lindenberg A, Domes G, Kirsch P, et al. Oxytocin and vasopressin in the human brain:Social neuropeptides for translational medicine. Nature Reviews Neuroscience, 2011, 12(9):524-538
17 Hollander E, Bartz J, Chaplin W, et al. Oxytocin increases retention of social cognition in autism. Biological Psychiatry, 2007, 61(4):498-503
18 Andari E, Duhamel JR, Zalla T, et al. Promoting social behavior with oxytocin in high-functioning autism spectrum disorders. Proceedings of the National Academy of Sciences, 2010, 107(9):4389-4394
19 Auyeung B, Lombardo MV, Heinrichs M, et al. Oxytocin increases eye contact during a real-time, naturalistic social interaction in males with and without autism. Translational Psychiatry, 2015, 5(2):e507
20 Aoki Y, Yahata N, Watanabe T, et al. Oxytocin improves behavioural and neural deficits in inferring others'social emotions in autism. Brain, 2014, 137(11):3073-3086
21 Guastella AJ, Einfeld SL, Gray KM, et al. Intranasal oxytocin improves emotion recognition for youth with autism spectrum disorders. Biological Psychiatry, 2010, 67(7):692-694
22 Anagnostou E, Soorya L, Chaplin W, et al. Intranasal oxytocin versus placebo in the treatment of adults with autism spectrum disorders:A randomized controlled trial. Molecular Autism, 2012, 3(1):16
23 Hollander E, Novotny S, Hanratty M, et al. Oxytocin infusion reduces repetitive behaviors in adults with autistic and Asperger's disorders. Neuropsychopharmacology, 2003, 28:193-198
24 Dadds MR, MacDonald E, Cauchi A, et al. Nasal oxytocin for social deficits in childhood autism:A randomized controlled Trial. Journal of Autism and Developmental Disorders, 2014, 44(3):521-531
25 Bakermans-Kranenburg MJ, van IJzendoorn MH. Sniffing around oxytocin:review and meta-analyses of trials in healthy and clinical groups with implications for pharmacotherapy. Translational Psychiatry, 2013, 3(5):e258
26 Leppanen J, Ng KW, Tchanturia K, et al. Meta-analysis of the effects of intranasal oxytocin on interpretation and expression of emotions. Neuroscience & Biobehavioral Review, 2017, 78:125-144
27 Ooi YP, Weng SJ, Kossowsky J, et al. Oxytocin and autism spectrum disorders:A systematic review and meta-analysis of randomized controlled trials. Pharmacopsychiatry, 2017, 50(1):5-13
28 Auyeung B, Lombardo MV, Heinrichs M, et al. Oxytocin increases eye contact during a real-time, naturalistic social interaction in males with and without autism. Translational Psychiatry, 2015, 5(2):e507
29 Domes G, Kumbier E, Heinrichs M, et al. Oxytocin promotes facial emotion recognition and amygdala reactivity in adults with Asperger syndrome. Neuropsychopharmacology, 2014, 39(3):698-706
30 Watanabe T, Abe O, Kuwabara H, et al. Mitigation of Sociocommunicational Deficits of Autism Through OxytocinInduced Recovery of Medial Prefrontal Activity. JAMA Psychiatry, 2014, 71(2):166
31 Watanabe T, Kuroda M, Kuwabara H, et al. Clinical and neural effects of six-week administration of oxytocin on core symptoms of autism. Brain, 2015, 138(11):3400-3412
32 Yatawara CJ, Einfeld SL, Hickie IB, et al. The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism:a randomized clinical crossover trial. Mol Psychiatry, 2016, 21(9):1225-1231
33 Guastella AJ, Gray KM, Rinehart NJ, et al. The effects of a course of intranasal oxytocin on social behaviors in youth diagnosed with autism spectrum disorders:a randomized controlled trial. Journal of Child Psychology and Psychiatry, 2015, 56(4):444-452
34 Kosaka H, Okamoto Y, Munesue T, et al. Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism:a 24-week randomized clinical trial. Translational Psychiatry, 2016, 6(8):e872
35 Munesue T, Nakamura H, Kikuchi M, et al. Oxytocin for Male Subjects with Autism Spectrum Disorder and Comorbid Intellectual Disabilities:A Randomized Pilot Study. Frontiers in Psychiatry, 2016. 7
36 Domes G, Heinrichs M, Kumbier E, et al. Effects of Intranasal Oxytocin on the Neural Basis of Face Processing in Autism Spectrum Disorder. Biological Psychiatry, 2013, 74(3):164-171
37 Gordon I, Vander Wyk BC, Bennett RH, et al. Oxytocin enhances brain function in children with autism. Proceedings of the National Academy of Sciences, 2013, 110(52):20953-20958
38 Shahrestani S, Kemp AH, Guastella AJ. The impact of a single administration of intranasal oxytocin on the recognition of basic emotions in humans:a meta-analysis. Neuropsychopharmacology, 2013, 38(10):1929-1936
39 Van I Jzendoorn MH, Bakermans-Kranenburg MJ. A sniff of trust:Meta-analysis of the effects of intranasal oxytocin administration on face recognition, trust to in-group, and trust to out-group. Psychoneuroendocrinology, 2012, 37(3):438-443
40 Wigton R, Radua J, Allen P, et al. Neurophysiological effects of acute oxytocin administration:systematic review and meta-analysis of placebo-controlled imaging studies. Journal of Psychiatry & Neuroscience, 2015, 40(1):E1-E22
41 LoParo D, Waldman I D. The oxytocin receptor gene(OXTR) is associated with autism spectrum disorder:A meta-analysis. Molecular Autism, 2015, 20(5):640-646
42 Trevisan D A, Birmingham E. Are emotion recognition abilities related to everyday social functioning in ASD? A metaanalysis. Research in Autism Spectrum Disorders, 2016, 32:24-42

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