吡贝地尔治疗帕金森病的系统评价

Systemic review of piribedil for treatment of Parkinson's disease

目的系统评价吡贝地尔治疗帕金森病(PD)的有效性和安全性。方法计算机检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM),查找以吡贝地尔治疗PD的随机对照试验(RCT),对纳入的RCT进行质量评价,采用Rev Man 5.1软件进行Meta分析。结果共纳入10项RCT,包括578例PD患者。Meta分析结果提示,吡贝地尔组的有效率明显高于对照组[RR=1.30,95%CI(1.15,1.46),P<0.0001];吡贝地尔组的UPDRSⅠ评分改善程度高于对照组[MD=-1.98,95%CI(-2.77,-1.18),P<0.00001]。吡贝地尔组的UPDRSⅡ评分和UPDRSⅢ评分改善与对照组无统计学差异(P>0.05)。吡贝地尔组的HAMD评分改善程度高于对照组[MD=-4.95,95%CI(-7.32,-2.57),P<0.0001]。吡贝地尔组的总不良事件、消化道症状和头晕发生率与对照组均无统计学差异(P>0.05)。结论吡贝地尔能够明显改善PD患者的运动症状和抑郁情绪,提高有效率,且不增加不良事件的发生。

Objective To evaluate systematically the clinical efficacy and safety of Piribedil for the treatment of Parkinson′s disease （PD）. Methods Randomized controlled trials（RCTs）about Piribedil for treatment of PD were searched in Cochrane Library,Medline,Embase and Chinese Biomedical Literature Database（CBM）. We assessed the quality of the RCTs and Meta - analysis was conducted by software Review Manager 5. 1. Results A total of 10 studies with 578 participants were included. The meta - analysis showed that the efficiency of piribedil group was significantly higher than the control group[RR = 1. 30,95% CI（1. 15,1. 46）,P 〈 0. 0001]. The improvement of unified Parkinson′s Dis-ease Rating Scale（UPDRS）Ⅰ in piribedil group was higher than the control group[MD =^-1. 98,95% CI（ - 2. 77,- 1. 18）,P 〈 0. 00001]. The improvement of UPDRS Ⅱand UPDRSⅢ between piribedil group and control group did not show statistically significant difference（ P 〉 0. 05）. The improvement of Hamilton Depression Scale（HAMD）in piribedil group was higher than control group[MD = - 4. 95,95% CI（ - 7. 32,- 2. 57）,P 〈 0. 0001]. The incidence of adverse events,gastrointestinal symptoms and dizziness did not have statistically significant difference between piribedil group and control group（ P 〉 0. 05）. Conclusion Piribedil can significantly relieve motor symptoms and depression in PD pa-tients without increasing the incidence of adverse events.