Objective  To systematically review the clinical efficacy of paroxetine plus olanzapine versus paroxetine alone among depression complicated with sleep disorder patients in China.

Methods  PubMed, Embase, Cochrane Library, CINAHL, SinoMed, CNKI, VIP, WanFang Data databases, SUMsearch and Google search engine were electronically searched to collect randomized controlled trials (RCTs) of paroxetine plus olanzapine versus paroxetine  in the treatment of depression complicated with sleep disorder Chinese patients from inception to April 3, 2023. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies, and the Meta-analysis was then performed by using RevMan 5.3 software.

Results  A total of 70 RCTs involving 5 683 patients were included. The results of Meta-analysis showed that: (1) the total effective rate in experimental group was significantly higher than that of the control group (OR=5.98, 95%CI 4.51 to 7.94, P<0.001); (2) Pittsburgh sleep quality index scores after treatment in the first month (MD=-2.81, 95%CI -3.24 to -2.38, P<0.001), in 2 months (MD=-2.41, 95%CI -3.13 to -1.70, P<0.001), in 3 months (MD=- 2.80, 95%CI -3.18 to -2.42, P<0.001) and in 6 months (MD=-1.65, 95%CI -1.83 to -1.48, P<0.001) in experimental group were significantly lower than the control group; (3) Hamilton depression scale scores after treatment in the first month (MD=-5.79, 95%CI -6.63 to -4.95, P<0.001), in 2 months (MD=-4.33, 95%CI -5.45 to -3.21, P<0.001), in 3 months (MD=- 3.76, 95%CI -4.17 to -3.34, P<0.001) and in 6 months (MD=-3.38, 95%CI -3.60 to -3.15, P<0.001) in experimental group were significantly lower than the control group; (4) Hamilton anxiety scale scores in experimental group were significantly lower than the control group (MD=-3.47, 95%CI -3.78 to -3.16, P<0.001).

Conclusion  Current evidence shows that, compared with the paroxetine alone in the treatment of depression complicated with sleep disorder patients in China, paroxetine plus olanzapine can effectively increase patients' total effective rate of clinical treatment, improve the sleep quality and depression symptoms in 1 month, 2 months, 3 months and 6 months after treatment, and also reduce patients’ anxiety. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

1.朱佳琪,张淑莉,刘蓓. 抑郁症的治疗研究进展综述——基于抗抑郁症药物科普分析[J]. 科技视界, 2023(13): 30-32. [Zhu JQ, Zhang SL, Liu B. Review of research progress in the treatment of depression: based on science popularization analysis of antidepressant drugs[J]. Science & Technology Vision, 2023(13): 30-32.] DOI: 10.3969/j.issn.2095-2457.2023.13.010.

2.李博文,李剑兰. 帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍的临床效果[J]. 中国医学创新, 2019, 16(19): 142-145. [Li BW, Li JL. The clinical effects of paroxetine combined with low dose olanzapine in the treatment of depression with sleep disorders[J]. Medical Innovation of China, 2019, 16(19): 142-145.] DOI: 10.3969/j.issn.1674-4985.2019.19.037.

3.袁伟. 帕罗西汀联合奥氮平在抑郁症并发睡眠障碍治疗中的效果观察[J]. 心理月刊, 2020, 15(15): 117. [Yuan W. Effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Psychologies Magazine, 2020, 15(15): 117.] DOI: 10.19738/j.cnki.psy.2020.15.086.

4.姚金娥,李明伟,管静,等. 奥氮平改善肿瘤相关性抑郁和焦虑患者生活质量的研究[J]. 现代肿瘤医学, 2016, 24(12): 1949-1952. [Yao JE, Li MW, Guan J, et al. Clinical research of olanzapine in improving quality of life in patients with cancer-related depression[J]. Journal of Modern Oncology, 2016, 24(12): 1949-1952.] DOI: 10.3969/j.issn.1672-4992.2016.12.030.

5.李清伟,陆峥. 失眠症与焦虑障碍和抑郁障碍的关系及其治疗[J]. 中华全科医师杂志, 2016, 15(7): 505-507. [Li QW, Lu Z. Relationship of insomnia with anxiety/depression and its management[J]. Chinese Journal of General Practitioners, 2016, 15(7): 505-507.] DOI: 10.3760/cma.j.issn.1671-7368.2016.07.003.

6.饶贵优. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍效果观察[J]. 北方药学, 2019, 16(7): 111-112. [Rao GY. Effect of paroxetine combined with olanzapine in the treatment of depression complicated with sleep disorder[J]. Journal of North Pharmacy, 2019, 16(7): 111-112.] DOI: 10.3969/j.issn.1672-8351.2019.07.079.

7.朱艳桥. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍效果分析[J]. 中国现代药物应用, 2018, 12(12): 135-136. [Zhu YQ. Effect of paroxetine plus olanzapine in the treatment of depression with sleep disorder[J]. Chinese Journal of Modern Drug Application, 2018, 12(12): 135-136.] DOI: 10.14164/j.cnki.cn11-5581/r.2018.12.078.

8.庞春霞. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍100例[J]. 中国药业, 2016, 25(9): 92-94. [Pang CX. Efficacy and adverse reaction of paroxetine combined with olanzapine in treating depression patients with sleep disorders in 100 cases[J]. China Pharmaceuticals, 2016,25(9): 92-94.] DOI: CNKI:SUN:YYGZ.0.2016-09- 031.

9.陈正平,余关茂,郭剑锋. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床观察[J]. 中国药师, 2015, 18(2): 273-275. [Chen ZP, Yu GM, Guo JF. Research on the treatment of depression with sleep disorders by paroxetine combined with olanzapine[J]. China Pharmacist, 2015, 18(2): 273-275.] DOI: 10.3969/j.issn.1008-049X. 2015.02.031.

10.罗祝平,徐孟松,马迎春. 帕罗西汀联合奥氮平治疗抑郁症并睡眠障碍效果观察[J]. 中国乡村医药, 2018, 25(20): 11-12. [Luo ZP, Xu MS, Ma YC. Effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Chinese Journal of Rural Medicine and Pharmacy, 2018, 25(20): 11-12.] DOI: 10.3969/j.issn.1006-5180.2018.20.006.

11.World Health Organization. International Classification of Diseases 11th Revision[EB/OL]. (2019-05-30) [2023-04-30]. https://icd.who.int/browse11/l-m/en.

12.中华医学会精神科分会, 编著. CCMD-3中国精神障碍分类与诊断标准(第三版)[M]. 济南: 山东科学技术出版社, 2001: 1-97.

13.Higgins JP, Green S. Cochrane Handbook for Systematic Review of Interventions Version 5.1.0[EB/OL]. (2011-03)[2023-04-03]. http://www.cochrane-handbook.org.

14.Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis[J]. Stat Med, 2002, 21(11): 1539-1558. DOI: 10.1002/sim.1186.

15.吴恩辉,杨致蓉,黄宁宁. 帕罗西汀联合小剂量奥氮平对轻度抑郁伴失眠患者生活质量的影响[J]. 中国现代医生, 2016, 54(35): 86-88, 92. [Wu EH, Yang ZR, Huang NN. Effect of paroxetine combined with low-dose olanzapine on the quality of life in patients with mild depression and insomnia[J]. China Modern Doctor, 2016, 54(35): 86-88, 92.] DOI: CNKI:SUN:SMZZ.0.2019-03-003.

16.孙福刚,陈雪莲,周海文,等. 罗西汀联合奥氮平对抑郁症并发睡眠障碍患者心理状态及睡眠质量的影响[J]. 中国药物经济学, 2021, 16(3): 55-57, 61. [Sun FG, Chen XL, Zhou HW, et al. Influence of paroxetine combined with olanzapine on mental state and sleep quality in patients with depression and sleep disorder[J].China Journal of Pharmaceutical Economics, 2021, 16(3): 55-57, 61.] DOI: 10.12010/j.issn.1673-5846.2021.03.013.

17.孟祥军,李正军. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的临床探讨[J]. 临床医药文献电子杂志, 2018, 5(16): 163-164. [Meng XJ, Li ZJ. Clinical study of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Electronic Journal of Clinical Medical Literature, 2018, 5(16): 163-164.] DOI: 10.3877/j.issn.2095-8242.2018.16.148.

18.庞金宇. 使用帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的价值研究[J]. 中文科技期刊数据库(文摘版)医药卫生, 2021(1): 38, 40. [Pang JY. The value of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Chinese Science and Technology Journal Database (Abstract Edition) Medicine and Health, 2021(1): 38, 40.] http://qikan.cqvip.com/Qikan/Article/Detail?id=1000002699572&from=Qikan_Search_Index.

19.廖宗铃, 陈海宽. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍患者的临床疗效分析[J]. 健康女性, 2021(3): 84. [Liao ZL, Chen HK. Clinical efficacy of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Healthy Women, 2021(3): 84.] https://d.wanfangdata.com.cn/periodical/QKBJBD20212022010700005562.

20.张建芳,莫燕琼. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍患者的临床效果分析[J]. 世界复合医学, 2019, 5(3): 122-124. [Zhang JF, Mo YQ. Clinical analysis of paroxetine combined with olanzapine in the treatment of patients with depression complicated with sleep disorders[J]. World Journal of Complex Medicine, 2019, 5(3): 122-124.] DOI: 10.11966/j.issn.2095-994X.2019.05.03.39.

21.张胜荣. 联用盐酸帕罗西汀和奥氮平治疗抑郁症并发睡眠障碍的效果研讨[J]. 当代医药论丛, 2018, 16(19): 150-152. [Zhang SR. Study on the effect of paroxetine hydrochloride combined with olanzapine in the treatment of depression with sleep disorders[J]. Contemporary Medicine Forum, 2018, 16(19): 150-152.] DOI: 10.3969/j.issn. 2095-7629.2018.19.109.

22.彭汝春. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者疗效观察[J]. 中国民康医学, 2015(2): 37-38. [Peng RC. Effect observation of paroxetine combined with small dose olanzapine in treatment of patients with depression associated with insomnia[J]. Medical Journal of Chinese People's Health, 2015(2): 37-38.] DOI: 10.3969/j.issn.1672-0369.2015.02.017.

23.徐阿娜. 抑郁症伴随睡眠障碍不同治疗方案临床疗效观察[J]. 中国卫生标准管理, 2021, 12(21): 92-95. [Xu AN. Clinical observation of different treatment regimens for depression with sleep disorder[J]. China Health Standard Management, 2019, 12(21): 92-95.] DOI: 10.3969/j.issn. 1674-9316.2021.21.030.

24.文晏,黄雪萍. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果分析[J]. 中国继续医学教育, 2018, 10(5): 135-136. [Wen Y, Huang XP. Analysis of clinical effect of paroxetine plus olanzapine in the treatment of depression and sleep disorder[J]. China Continuing Medical Education, 2018, 10(5): 135-136.] DOI: 10.3969/j.issn.1674-9308.2018.05.066.

25.朱列和,吴明,陈晓莹. 帕罗西汀合并小剂量奥氮平治疗抑郁症伴失眠的对照研究[J]. 北方药学, 2016, 13(11): 56-57. [Zhu LH, Wu M, Chen XY. A comparative study of paroxetine combined with low-dose olanzapine in the treatment of depression with insomnia[J]. Journal of North Pharmacy, 2016, 13(11): 56-57.] DOI: CNKI:SUN:BFYX.0.2016-11-048.

26.李晓伟, 付建国. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍效果及对患者觉醒时间和觉醒次数影响观察[J]. 临床医药文献电子杂志, 2018, 5(91): 66-67. [Li XW, Fu JG. Effect of paroxetine combined with olanzapine in the treatment and influence on wake time and wake frequency among depression with sleep disorder patients[J]. Electronic Journal of Clinical Medical Literature, 2018, 5(91): 66-67.] DOI: 10.3877/j.issn. 2095-8242.2018.91.047.

27.王亚倩,董辛. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的效果分析[J]. 深圳中西医结合杂志, 2021, 31(4): 185-186. [Wang YQ, Dong X. Effect analysis of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2021, 31(4): 185-186.] DOI: 10.16458/j.cnki.1007-0893. 2021.04.091.

28.盛海涛,王伊莞,王爱玲. 奥氮平治疗老年卒中患者失眠伴抑郁症的临床效果和用药不良反应观察 [J]. 家庭医药·就医选药, 2020(10): 184-185. [Sheng HT, Wang YG, Wang AL. Clinical effects and adverse reactions of olanzapine in the treatment of insomnia with depression in elderly stroke patients[J]. Family Medicines. Pharmaceutical Selection for Medical Treatment, 2020(10): 184-185.] https://doc.taixueshu.com/journal/20205275jtyy.html.

29.秦彩丽. 探究帕罗西汀联合奥氮平在治疗抑郁症并发睡眠障碍中的效果[J]. 中国实用医药, 2021, 16(11): 168-170. [Qin CL. To explore the effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. China Practical Medical, 2021, 16(11): 168-170.] DOI: 10.14163/j.cnki.11-5547/r.2021.11.062.

30.耿英华. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍患者的临床观察[J]. 当代医学, 2021, 27(16): 142-143. [Geng YH. Clinical observation of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Contemporary Medicine, 2021, 27(16): 142-143.] DOI: 10.3969/j.issn.1009-4393.2021.16.058.

31.腾丽娟. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍疗效观察[J]. 河南医学研究, 2016, 25(8): 1439-1440. [Teng LJ. Effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Henan Medical Research, 2016, 25(8): 1439-1440.] DOI: 10.3969/j.issn.1004-437X.2016.08.055.

32.董朝卿. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者临床疗效观察[J]. 医药卫生, 2022(1): 57-60. [Dong CQ. Clinical effect of paroxetine combined with low-dose olanzapine in the treatment of depression with insomnia[J]. Medicine and Health, 2022(1): 57-60.] http://qikan.cqvip.com/Qikan/Article/Detail?id=1000003523781.

33.裴晓媛. 帕罗地汀联合奥氮平治疗抑郁症并发睡眠障碍的临床疗效和药品不良反应[J]. 世界最新医学信息文摘, 2016, 16(91): 113-114. [Pei XY. Clinical efficacy and adverse drug reactions of paroditine combined with olanzapine in the treatment of depression with sleep disorders[J]. World Latest Medicine Information, 2016, 16(91): 113-114.] DOI: 10.3969/j.issn.1671-3141.2016. 91.088.

34.赵丽丽,康晓辉,李现峰. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的临床效果[J]. 保健医学研究与实践, 2018, 15(3): 61-63. [Zhao LL, Kang XH, Li XF. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Health Medicine Research and Practice, 2018, 15(3): 61-63.] DOI: 10.11986/j.issn.1673-873X.2018.03.014.

35.陈金稳. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床观察[J]. 大家健康, 2015, 9(22): 130-131. [Chen JW. Clinical observation of paroxetine combined with olanzapine in the treatment of depression complicated with sleep disorders[J]. For All Health, 2015, 9(22): 130-131.] DOI: 10.3969/j.issn.1009-6019.2015.11.149.

36.饶晓红. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍患者的临床疗效[J]. 医疗装备, 2018, 31(20): 145-146. [Rao XH. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Chinese Journal of Medical Device, 2018, 31(20): 145-146.] DOI: 10.3969/j.issn.1002-2376.2018. 20.108.

37.鲁晓亮,段芙蓉. 帕罗西汀+奥氮平治疗抑郁症并发睡眠障碍的临床效果观察[J]. 心理医生, 2018, 24(30): 84-85. [Lu XL, Duan FR. Clinical effect of paroxetine and olanzapine in the treatment of depression complicated with sleep disorders[J]. Psychological Doctor, 2018, 24(30): 84-85.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE4MzAwNjgaCDRlMmRvZXI0.

38.鲁莉侠. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者的临床效果[J]. 心理医生, 2016, 22(19): 28-29. [Lu LX. The clinical effect of paroxetine combined with small dose of olanzapine on depression patients associated with insomnia[J]. Psychological Doctor, 2016, 22(19): 28-29.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE2MTkwMjAaCGFlZW5vZjV3.

39.付园园. 帕罗西汀与奥氮平联合治疗抑郁症合并睡眠障碍患者的疗效及不良反应[J]. 中国医药指南, 2021, 19(9): 106-107. [Fu YY. Efficacy and adverse reactions of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Guide of China Medicine, 2021, 19(9): 106-107.] https://www.cnki.com.cn/Article/CJFDTotal-YYXK202109051.htm.

40.刘雪朋. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果分析[J]. 中文科技期刊数据库(全文版) 医药卫生, 2022(7): 42-45. [Liu XP. Clinical effect analysis of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Chinese Science and Technology Journal Database (full-text edition) Medicine and Health, 2022(7): 42-45.] http://qikan.cqvip.com/Qikan/Article/Detail?id=1000003509545.

41.夏青. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的临床疗效分析[J]. 中国社区医师, 2022, 38(7): 41-43. [Xia Q. Clinical efficacy of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Chinese Community Doctors, 2012, 38(7): 41-43.] DOI: 10.3969/j.issn.1007-614x.2022.07.013.

42.杨成超. 观察帕罗西汀与奥氮平联合治疗抑郁症合并睡眠障碍患者的疗效及不良反应[J]. 中国药物经济学, 2018, 13(7): 46-48. [Yang CC. Observing the efficacy and side effects of Pa Rossi Dean and olanzapine in the treatment of depression patients with sleep disorders[J]. China Journal of Pharmaceutical Economics, 2018, 13(7): 46-48.] DOI: 10.12010/j.issn.1673-5846.2018.07.014.

43.杨栋梁. 帕罗西汀与小剂量奥氮平联用对抑郁症患者伴有失眠的临床疗效与安全性评价[J]. 抗感染药学, 2018, 15(6): 1071-1073. [Yang DL. Clinical efficacy and safety evaluation of paroxetine combined with low-dose olanzapine among depression with insomnia patients[J]. Anti-Infection Pharmacy, 2018, 15(6): 1071-1073.] DOI: 10.13493/j.issn.1672-7878.2018.06-057.

44.王梦觉. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果体会[J]. 健康大视野, 2018(5): 85. [Wang MJ. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Health Horizon, 2018(5): 85.] DOI: 10.3969/j.issn.1005- 0019.2018.05.096.

45.王飞雪. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者的临床疗效[J]. 中国药物经济 学,  2015(z1): 104-105. [Wang FX. Clinical effect of paroxetine combined with low-dose olanzapine in the treatment of depression with insomnia[J]. China Journal of Pharmaceutical Economics, 2015(z1): 104-105.] DOI: CNKI:SUN:ZYWA.0.2015-S1-073.

46.王鸿儒. 帕罗西汀合并小剂量奥氮平治疗抑郁症伴失眠患者的对照研究[D]. 济南: 山东大学, 2012. DOI: 10.7666/d.Y2179621.

47.迟云鹏. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果分析[J]. 中国保健营养, 2020, 30(2): 305-306. [Chi YP. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. China Health Care & Nutrition, 2020, 30(2): 305-306.] https://doc.taixueshu.com/journal/20200593zgbjyy-kp.html.

48.邹颋. 分析奥氮平联合帕罗西汀改善抑郁症患者睡眠障碍的效果及安全性[J]. 东方药膳, 2022(18): 71-72. [Zou T. Analysis of the efficacy and safety of olanzapine combined with paroxetine in improving sleep disorders with depression patients[J]. Oriental Medicinal Food, 2022(18): 71-72.] http://www.dfysbjb.com/upload/P44657c2ea2ff4a4e9fdcb39d5c81e775.pdf.

49.高照莲. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍患者的临床疗效分析[J]. 健康大视野, 2018(23): 44-45. [Gao ZL. Clinical efficacy of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Health Horizon, 2018(23): 44-45.] DOI: 10.3969/j.issn.1005-0019.2018.23.062.

50.于方舟,何茹. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的效果观察[J]. 中国当代医药, 2021, 28(22): 103-106. [Yu FZ, He R. Effect observation of Paroxetine combined with Olanzapine in the treat-ment of depression complicated with sleep disorder[J]. China Modern Medicine, 2021, 28(22): 103-106.] DOI: 10.3969/j.issn. 1674-4721.2021.22.030.

51.候宁. 探讨帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍的临床效果和药品不良反应[J]. 人人健康, 2020(13): 71. [Hou N. To investigate the clinical effect and adverse drug reactions of paroxetine combined with low dose olanzapine in the treatment of depression with sleep disorders[J]. Health for Everyone, 2020(13): 71.] https://www.cnki.com.cn/Article/CJFDTotal-RRJK202013062.htm.

52.杨冬林,刘立芬,郝英霞,等. 帕罗西汀联合小剂量奥氮平对抑郁症伴失眠患者睡眠进程和睡眠结构的影响[J]. 中国药房, 2016, 27(6): 743-745. [Yang DL, Liu LF, Hao YX, et al. Effect of paroxetine combined with low dose of olanzapine on sleep process and architecture of depression patients with insomnia[J]. China Pharmacy, 2016, 27(6): 743-745.] DOI: 10.6039/j.issn.1001-0408. 2016.06.08.

53.萧灿宏,黄芳远. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者临床疗效观察[J]. 饮食保健, 2019, 6(46): 53-54. [Xiao CH, Huang FY. Clinical efficacy of paroxetine combined with low dose olanzapine in the treatment of depression with insomnia[J]. Diet Health, 2019, 6(46): 53-54.] https://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_yinsbj201946067.

54.贺守彬. 帕罗西汀+奥氮平治疗抑郁症伴失眠的效果 [J]. 中国卫生标准管理, 2020, 11(1): 72-74. [He SB. Effect of paroxetine combined with olanzapine in the treatment of depression with insomnia china health standard management[J]. China Health Standard Management, 2019,11(1): 72-74.] DOI: 10.3969/j.issn. 1674-9316.2020.01.030.

55.赵玲. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者临床疗效观察[J]. 健康必读, 2021(17): 73. [Zhao L. Clinical efficacy of paroxetine combined with low dose olanzapine in the treatment of depression with insomnia[J]. Health Required, 2021(17): 73.] https://doc.taixueshu.com/journal/20212421jkbd001.html.

56.陶司磊. 帕罗西汀联合奥氮平对抑郁症并发睡眠障碍患者的临床疗效探讨[J]. 心理医生, 2018, 24(15): 145-146. [Tao SL. Clinical efficacy of paroxetine combined with olanzapine among depression patients with sleep disorders[J]. Psychological Doctor, 2018, 24(15): 145-146.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE4MTUxMTgaCHA2dHpsOGEy.

57.冉芬. 帕罗西汀与小剂量奥氮平联合治疗抑郁伴失眠的疗效探讨[J]. 大家健康, 2017, 11(9): 147. [Ran F. Efficacy of paroxetine combined with low dose olanzapine in the treatment of depression with insomnia[J]. Good Health for All, 2017, 11(9): 147.] https://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_dajjk201709188.

58.吴磊. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠患者临床疗效分析[J]. 黑龙江医药, 2015, 28(6): 1246-1248. [Wu L. Clinical efficacy of paroxetine combined with low dose olanzapine in the treatment of depression with insomnia[J]. Heilongjiang Medicine Journal, 2015, 28(6): 1246-1248.] DOI: 10.14035/j.cnki.hljyy.2015.06.030.

59.尚兴盈. 抑郁症伴失眠患者经帕罗西汀合并小剂量奥氮平治疗的效果观察[J]. 心理医生, 2016, 22(15): 125-126. [Shang XY. Effect of paroxetine combined with low dose olanzapine on patients with depression and insomnia[J]. Psychological Doctor, 2016, 22(15): 125-126.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE2MTUxMDYaCDNmY2FzemZ2.

60.方明. 帕罗西汀联合小剂量奥氮平治疗抑郁症伴失眠的临床疗效[J]. 临床合理用药杂志, 2019, 12(12): 69-71. [Fang M. The clinical effect of paroxetine combined with low dose olanzapine in the treatment of depression with insomnia[J]. Chinese Journal of Clinical Rational Drug Use, 2019, 12(12): 69-71.] DOI: 10.15887/j.cnki.13-1389/r.2019.12.033.

61.南晓荣,郭琴琴. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果分析[J]. 科学养生, 2019, (12): 93-94. [Nan XR, Guo QQ. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorder[J]. Science and Health, 2019, (12): 93-94.] https://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_kxys201912109.

62.孟召海. 帕罗西汀联合奥氮平对抑郁症并发睡眠障碍的应用效果[J]. 特别健康, 2019(35): 115. [Meng ZH. The effect of paroxetine combined with olanzapine on depression with sleep disorders[J]. Special Health, 2019(35): 115.] DOI: 10.3969/ j.issn.2095-6851.2019.35.155.

63.廖英. 多导睡眠监测仪监测帕罗西汀联合奥氮平治疗抑郁症睡眠障碍的疗效探讨[J]. 中外医疗, 2017, 36(34): 19-21. [Liao Y. Study on curative effect of polysomnography in monitoring the paroxetine and olanzapine treatment of depression sleep disorder[J]. China Foreign Medical Treatment, 2017, 36(34): 19-21.] DOI: 10.16662/j.cnki.1674-0742.2017.34.019.

64.张晓,罗玉霞. 帕罗西汀联合奥氮平治疗抑郁症并睡眠障碍的临床效果观察[J]. 心理医生, 2018, 24(35): 160-161. [Zhang X, Luo YX. Clinical effect of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Psychological Doctor, 2018, 24(35): 160-161.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE4MzUxMzYaCDYzZDZmd3l2.

65.张海涛. 帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍的价值[J]. 世界睡眠医学杂志, 2020, 7(6): 955-957. [Zhang HT. The Value of Paroxetine Combined with Olanzapine in the Treatment of Depression Complicated with Sleep Disorder[J]. World Journal of Sleep Medicine, 2020, 7(6): 955-957.] DOI: 10.3969/j.issn. 2095-7130.2020.06.009.

66.徐冰. 抑郁症并发睡眠障碍应用帕罗西汀+奥氮平治疗的效果分析[J]. 世界最新医学信息文摘, 2019, 19(16): 169, 171. [Xu B. Effect analysis of paroxetine plus olanzapine in the treatment of depression complicated with sleep disorder[J]. World Latest Medicine Information Abstracts, 2019, 19(16): 169, 171.] DOI: 10.19613/j.cnki. 1671-3141.2019.16.095.

67.李大坤. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床分析[J]. 世界最新医学信息文摘, 2016(92): 2. [Li DK. Clinical analysis of paroxetine plus olanzapine in the treatment of depression complicated with sleep disorder[J]. World Latest Medicine Information, 2016(92): 2.] DOI: 10.3969/j.issn.1671-3141.2016.92.013.

68.李志鹏,佘继祥,李家磊,等. 帕罗西汀联合不同剂量奥氮平治疗抑郁症伴睡眠障碍患者的临床疗效观察[J]. 中国现代药物应用, 2022, 16(18): 27-30. [Li ZP, She JX, Li JL, et al. Clinical observation of paroxetine combined with different doses of olanzapine in the treatment of patients with depression and sleep disorders[J]. Chinese Journal of Modern Drug Application, 2022, 16(18): 27-30.] DOI: 10.14164/j.cnki.cn11-5581/r.2022.18.007.

69.李晶晶. 帕罗西汀联合奥氮平对抑郁症并发睡眠障碍的疗效与安全性评价[J]. 心理医生, 2018, 24(32): 92-93. [Li JJ. Efficacy and safety evaluation of paroxetine combined with olanzapine in the treatment of depression with sleep disorders[J]. Psychological Doctor, 2018, 24(32): 92-93.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94bHlzLXgyMDE4MzIwNzcaCDZucHB4NHAx.

70.林三妹. 奥氮平与帕罗西汀结合用于抑郁症并发睡眠障碍治疗临床分析[J]. 世界最新医学信息文摘, 2017, 17(52): 160-161. [Lin SM. Clinical analysis of olanzapine plus paroxetine in the treatment of depression complicated with sleep disorders[J]. World Latest Medicine Information, 2017, 17(52): 160-161.] DOI: 10.3969/j.issn.1671-3141.2017.52.078.

71.段能. 帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床效果观察[J]. 中国社区医师, 2018, 34(31): 63-64. [Duan N. Clinical effect observation of paroxetine combined with olanzapine in the treatment of depression combined with sleep disorders[J]. Chinese Community Doctors, 2018, 34(31): 63-64.] DOI: 10.3969/j.issn.1007-614x.2018.31.038.

72.鲜晓华. 抑郁症并发睡眠障碍患者的临床治疗中帕罗西汀联合奥氮平的应用效果[J]. 健康必读, 2021(14): 58, 66. [Xian XH. Application effect of paroxetine combined with olanzapine in the clinical treatment of patients among depression with sleep disorders[J]. Health Required, 2021(14): 58, 66.] https://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_jkbd001202114095.

73.齐艳. 帕罗西汀联合奥氮平对抑郁症并发睡眠障碍患者的疗效及安全性[J]. 天津药学, 2017, 29(6): 55-57. [Qi Y. Efficacy and safety of paroxetine combined with tacrolimus in the treatment of patients in depression associated with sleep disorder[J]. Tianjin Pharmacy, 2017, 29(6): 55-57.] DOI: 10.3969/j.issn.1006-5687.2017.06.018.

74.彭成国,王高华,张新风,等. 帕罗西汀合并小剂量奥氮平治疗抑郁症伴失眠患者的对照研究[J]. 海南医学院学报, 2014, 20(9): 1289-1290, 1293. [Peng CG, Wang GH, Zhang XF, et al. Controlled study of paroxetine combing with a small dose of olanzapine in the treatment of depression in patients with insomnia[J]. Journal of Hainan Medical University, 2014, 20(9): 1289-1290, 1293.] DOI: 10.13210/j.cnki.jhmu.20140430.015.

75.武善田. 帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍的临床效果[J]. 世界最新医学信息文摘, 2020, 20(67): 134-135. [Wu ST. Clinical effect  of paroxetine combined with low dose olanzapine in thetreatment of depression with sleep disorders[J]. World Latest Medicine Information, 2020, 20(67): 134-135.] DOI: 10.3969/j.issn.1671-3141.2020.67.066.

76.徐健雄,段炼,徐世超,等. 帕罗西汀联合小剂量奥氮平对轻度抑郁伴失眠患者生命质量的影响[J]. 世界睡 眠医学杂志, 2019, 6(3): 255-256. [Xu JX, Duan L, Xu SC, et al. Effect of paroxetine combined with low-dose olanzapine on quality of life in patients with mild depression and insomnia[J]. World Journal of Sleep Medicine,2019,6(03): 255-256.] DOI: 10.3969/j.issn.2095-7130.2019.03.003.

77.陈晨,李桂芬. 观察帕罗西汀联合小剂量奥氮平治疗抑郁症合并睡眠障碍的治疗效果[J]. 世界睡眠医学杂志, 2022, 9(1): 18-20, 23. [Chen C, Li GF. Effect of paroxetine combined with low dose olanzapine in the treatment of depression complicated with sleep disorder[J]. World Journal of Sleep Medicine, 2022, 9(1): 18-20, 23.] DOI: 10.3969/j.issn.2095-7130.2022.01.005.

78.王传文. 帕罗西汀联合小剂量奥氮平对轻度抑郁伴失眠患者的疗效观察[J]. 中国冶金工业医学杂志, 2021, 38(1): 80-81. [Wang CW. Efficacy of paroxetine combined with low dose olanzapine in mild depression patients with insomnia[J]. Chinese Medical Journal of Metallurgical Industry, 2021, 38(1): 80-81.] https://med.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_zgyjgyyxzz202101075.

79.陈晓红. 盐酸帕罗西汀合并小剂量奥氮平治疗抑郁症伴失眠的临床分析[J]. 中西医结合心血管病杂  志, 2016, 4(18): 59, 62. [Chen XH. Clinical analysis of paroxetine hydrochloride plus low dose olanzapine in the treatment of depression with insomnia[J]. Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine, 2016, 4(18): 59, 62.] DOI: 10.16282/j.cnki.cn11-9336/r.2016.18.044.

80.Ohayon MM, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders[J]. J Psychiatr Res, 2003, 37(1): 9-15. DOI: 10.1016/s0022-3956(02)00052-3.

81.Baglioni C, Battagliese G, Feige B, et al. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies[J]. J Affect Disord, 2011, 135(1-3): 10-19. DOI: 10.1016/j.jad.2011.01.011.

82.Moore RY, Speh JC. Serotonin innervation of the primate suprachiasmatic nucleus[J]. Brain Res, 2004, 1010(1-2): 169-173. DOI: 10.1016/j.brainres.2004.02.024.

83.贾菲,臧彦楠,牛梦溪,等. 帕罗西汀片药品集中采购中标药疗效与安全性的真实世界研究[J]. 药物流行病学杂志, 2023, 32(1): 18-24. [Jia F, Zang YN, Niu MX, et al. Efficacy and safety of generic paroxetine tablets in centralized drug procurement: a real-world study[J]. Chinese Journal of Pharmacoepidemiology, 2023, 32(1): 18-24.] DOI: 10.19960/j.issn.1005-0698.202301003.

84.Vieta E, Colom F. Therapeutic options in treatment-resistant depression[J]. Ann Med, 2011, 43(7): 512-530.DOI: 10.3109/07853890.2011.583675.

85.刘津池,刘畅,华成舸. 随机对照试验偏倚风险评价工具RoB2(2019修订版)解读[J]. 中国循证医学 杂志, 2021, 21(6): 737-744. [Liu JC, Liu C, Hua CG. Risk bias assessment tool RoB2 (revised version 2019) for randomized controlled trial :an interpretation[J]. Chinese Journal of Evidence-Based Medicine, 2021, 21(6): 737-744.] DOI: 10.7507/1672-2531.202011144.