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register hereBackground: Obsessive-compulsive disorder (OCD) ranks as the fourth most prevalent psychiatric disorder, with selective serotonin reuptake inhibitors (SSRIs) as its mainstay pharmacological treatment. However, approximately 40 to 60% of patients do not adequately respond to initial treatment, highlighting the need for alternative options.

。然而，大约40%至60%的患者对初始治疗没有充分反应，突出了替代选择的必要性。

N-acetylcysteine (NAC) is one of the several medications that have been used in augmentation with SSRIs to enhance their efficacy. Objectives: We aimed to investigate the safety and efficacy of NAC, a glutamate-modulating agent, as an augmentation in the treatment of moderate to severe OCD.We conducted a thorough search across PubMed, Scopus, Web of science, and ProQuest to identify relevant trials published until December 2023.

N-乙酰半胱氨酸（NAC）是用于增强SSRIs以增强其功效的几种药物之一。目的：我们旨在研究谷氨酸调节剂NAC作为中重度强迫症治疗增强剂的安全性和有效性。我们在PubMed，Scopus，Web of science和ProQuest上进行了彻底的搜索，以确定2023年12月之前发表的相关试验。

The primary outcome of interest was the mean difference between the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores before and after administrating augmented NAC among patients with moderate to severe OCD. Furthermore, we compared the occurrence of adverse drug events between the experimental and control groups.

感兴趣的主要结果是中度至重度强迫症患者服用增强NAC前后耶鲁-布朗强迫症量表（Y-BOCS）评分的平均差异。此外，我们比较了实验组和对照组之间不良药物事件的发生率。

Results: We included six randomized controlled trials with 195 patients. The results of our study indicated a positive outcome for the experimental group in terms of the total Y-BOCS score when using the medication for a period of five to eight weeks (p-Value = 0.05). However, no significant difference was observed for durations shorter than five weeks or longer than 12 weeks.

结果：我们纳入了6项随机对照试验，共195名患者。我们的研究结果表明，当使用药物5至8周时，实验组在总Y-BOCS评分方面取得了积极的结果（p值=0.05）。然而，对于短于5周或长于12周的持续时间，没有观察到显着差异。

Additionally, no significant difference was found between the two groups in terms of the obsession and compulsion Y-BOCS scores. Furthermore, no significant differences were observed in terms of adverse events. Conclusion: Augmentation of NAC with SSRIs may benefit patients with moderate to severe OCD.

此外，在强迫和强迫Y-BOCS评分方面，两组之间没有发现显着差异。此外，在不良事件方面没有观察到显着差异。结论：SSRIs增强NAC可能有益于中重度强迫症患者。

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