丁苯酞软胶囊治疗血管性认知功能障碍的系统综述

Meta analysis of effects of butylphthalide soft capsules on vascular cognitive impairment

目的综合评价丁苯酞软胶囊治疗血管性认知功能障碍（包括VaD、VCI—ND、VCI—AD）的有效性及安全性。方法计算机检索万方数据库、MEDLINE、EMBAS、中国生物医学文献数据库、中国学术期刊全文数据库、PubMed、HairWire数据库，检索时间为该库最早时间至现在，收集丁苯酞软胶囊治疗血管性认知功能障碍相关性的文献。应用RevMan4．2．10软件对各个纳入研究的结果进行一致性检验和数据合并，并评估发表偏倚。结果共纳入5个研究，合计494例患者。Meta分析结果显示：丁苯酞软胶囊治疗组疗效好于对照组FOR=2．34，95％CI（1．16，4．71）]；治疗末MMSE量表评分Meta分析[OR=3．71，WMD95％CI（2．07，5．35）]；治疗末ADL量表评分Meta分析EoR=1．45，WMD95％CI（-6．36，3．47）]；治疗末CDR量表评分Meta分析[OR=-0．57，WMD95％CI（-1．41，0．27）]。结论丁苯酞软胶囊治疗血管性认知功能障碍有效，MMSE量表评分提高丁苯酞治疗组较对照组明显，但其ADL量表、CDR量表评分改善情况不肯定，安全性有待于进一步研究。

Objective To evaluate the effect of Butylphthalide Soft Capsules on Vascular cognitive impairment. Methods Such databases as WanFang, MEDLINE, EMBAS, CBMdisc, CNKI, PubMed, HairWire Data were searched from their establishment year to August 2011 to collect the literature about the Butylphthalide Soft Capsules on Vascular cognitive impairment. Analysis was performed on the homogeneity test and overall effect test of 5 randomized controlled trials of Butylphthalide Soft Capsules in treating vascular cognitive impairment. RevMan 4. 2. 1 was adopted to conduct consistency check and datamerging,and to evaluate publication bias. Results Butylphthalide Soft Capsules can improve the symptomatic of VCI compared to controls （P 〉 0.05）, and its pooled odds ratios and 95%CI was 2.34 （1.16 to 4.71）in the MMSE score （P 〈 0.05）, the weighted mean differences（ WMD ） and 95%CI was 3.71（2.07 to 5.35） ,in the ADL score （P〈 0.05）, the weighted mean differences （ WMD ） and 95%CI was -1.45（-6.63,3.47） ,in the CDR score （P 〈 0.05）, the weighted mean differences （ WMD ） and 95%CI was -0.57（-1.41,0. 27）. Conclusions Butylphthalide Soft Capsules was more effective than the conventional therapies in treating vascular cognitive impairment,and MMSE scale improved more sig nificantly in the treatment group than in the phthalocyanine control group. However, ADL, CDR scales improvement was not conclusive,and the safety need to be further studied.