重复经颅磁刺激治疗非痴呆性血管性认知障碍的Meta分析

Efficacy of Repetitive Transcranial Magnetic Stimulation on Patients with Vascular Cognitive Impairment no Dementia:A Meta-Analysis

目的：对重复经颅磁刺激治疗非痴呆性血管性认知障碍（VCIND）的疗效进行Meta分析。方法：计算机检索PubMed、EMbase、Cochrane library、CNKI、VIP、CBM和万方数据库中关于重复经颅磁刺激改善非痴呆性血管性认知障碍的随机对照试验（RCT）,同时追溯纳入文献的参考文献。检索时限均为从建库至2017年8月。由2名评价员按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果：共纳入6个RCT,246例患者（试验组n=123,对照组n=123）。Meta分析结果显示,与对照组相比,低频rTMS治疗能够改善VCIND患者的总体认知功能[SMD=1.15,95%CI（0.59,1.71）,P=0.000 1],缩短了P300潜伏期[SMD=-7.68,95%CI（-11.66,-3.71）,P=0.000 1],提高了MBI评分[SMD=0.53,95%CI（0.05,1）,P=0.03]。结论：低频rTMS可在一定程度上改善VCIND患者的认知功能,提高患者的自我生活能力。

Objective： To systematically review the efficacy of repetitive transcranial magnetic stimula- tion （rTMS） on patients with Vascular Cognitive Impairment no Dementia （VCIND）. Methods： We searched databases including PubMed, EMbase, Cochrane library, CNKI, VIP, CBM and WanFang from inception to August 2017 to collect randomized controlled trials （RCTs） about rT- MS for patients with VCIND. Two reviewers independently screened articles according to the in- clusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then, a meta-analysis was performed by using RevMan 5.3 software. Results： A total of 6 RCTs involving 246 VCIND patients were included. The results of meta-analysis showed that compared with the control group, low frequency rTMS（Lf-rTMS） treatment could significantly improve the overall cognitive abilities of VCIND patients （SMD= 1. 15,95%CI[-0. 59,1.71],P= 0. 000 1）. The P300＇s latency were significantly shorter in the LF-rTMS group than in the control group （SMD=- 7. 68,95% CI [- -- 11. 66, -- 3. 711, P = 0. 000 1 ） while MBI were significantly higher （SMD=0. 53,95% CIE0. 05 ,11 ,P=0.03）. Conclusion： LF-rTMS may benefit the cognitive abili ties of VCIND patients and improve the patients self-care ability.