摘要
目的:系统评价奥拉西坦治疗血管性认知功能障碍的疗效与安全性,为临床应用提供循证依据。方法:计算机检索PubMed、Embase、Cochrane library、中国知网、维普资讯和万方数据库,检索时间均从建库至2018年4月28日,根据是否使用奥拉西坦将患者分为试验组(2325例)和对照组(2311例),同时根据对照组是安慰剂对照或者其他药物治疗对照分为安慰剂对照组(1072例)和阳性对照组(1239例),并用RevMan5.3和Stata14.0软件分别进行Meta分析、发表偏倚和敏感性分析。结果:Meta分析结果显示:①疗效:奥拉西坦在提高患者智力精神水平方面有显著疗效,相比安慰剂和其他药物显著提高了简明智力状态检查表评分(MD=5.29, P <0.01)和蒙特利尔认知量表评分(MD=4.32, P<0.01);在改善患者日常生活能力方面,Barthel指数评定量表证明其有显著疗效(MD=18.71,P<0. 01),但日常生活能力量表评分显示奥拉西坦与安慰剂和其他药物间无差异;奥拉西坦治疗总有效率显著高于其他治疗(P<0.01)。②安全性:奥拉西坦治疗血管性认知功能障碍的安全性较好,无严重不良反应发生,与安慰剂和其他药物相比,差异无统计学意义(P>0.05)。结论:基于当前临床证据,奥拉西坦治疗血管性认知功能障碍疗效更优,安全性更好。
Objective :To systematically evaluate the therapeutic efficacy and safety of oxiracetam in patients with vascular cognitive impairment (VCI).Methods:Databases of PuhMed,Embase,Cochrane library,CNKI,VIP and Wanfang data were searched.The retrieval time was from inception to April 28th,2018.Patients were divided into the experimental group (2325 cases)and the control group (2311 cases)according to whether or not olracetam was used.The control group was divided into placebo control group (1072 cases)and positive control group (1239 cases)according to whether the control group was a placebo-controlled or other drug-treated control Meta-anal- ysis,publication bias and sensitivity evaluation were conducted respectively with RevMan 5.3 software and Stata 14.0 software.Results: Results of Meta-analysis showed that oxiracetam had significant effect in improving the mental level of patients,which couldsignificantly improve the MMSE score (MD =5.29,P <0.01 )and MOCA score (MD =4.32,P <0.01 )compared with placebo and other drugs.The analysis with Barthel index (BI)rating scale indicated that oxiracetamhad significant efficacy in improving patients'daily living ability (MD =18.71,P <0.01 )but the ADL score showed no difference between oxiracetam and placebo and other drugs.The total effective rate of oxiracetam was significantly higher than other treatments (P <0.01 ).Oxiracetam was safe for the treatment of VCI without serious adverse reactions,with no statistical differences compared with placebo and other drugs (P >0.05 ).Conclusion :According to the current clinical evidence,oxiracetam is effective and safe for the treatment of VCI.
作者
王钰
董文靓
倪倩
胡欣
封宇飞
WANG Yu;DONG Wen-liang;NI Qian;HU Xin;FENG Yu-fei(Department of Pharmacy,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Department of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Science,Peking University,Beijing 100083,China;College of Life Science and Biopharmaceutics ,Shenyang Pharmaceutical University,Shenyang 110016,China)
出处
《临床药物治疗杂志》
2019年第1期54-59,共6页
Clinical Medication Journal
