丁苯酞治疗卒中后认知功能障碍的系统评价

Butylphthalide in the Treatment of Post-stroke Cognitive Impairment:a Systematic Review

目的系统评价丁苯酞治疗卒中后认知功能障碍(PSCI)的疗效。方法计算机检索电子数据库,人工检索相关资料,纳入全球范围内丁苯酞治疗卒中后认知障碍的随机对照试验(RCT)研究,应用Cochrane系统评价的方法进行评价。结果共纳入8篇RCT(815例病人),纳入5个阳性对照、2个空白对照和1个安慰剂对照试验。随访期6个月末。Meta分析结果显示:(1)1个阴性对照和2个阳性对照研究显示,丁苯酞能明显改善卒中后病人认知功能障碍(P<0.05)。(2)量表评定卒中后认知障碍改善情况:1个安慰剂对照研究采用临床痴呆评定量表(CDR)和临床印象变化量表(CIBIC),4个阳性对照研究和2个阴性对照研究采用简易智能精神状态量表(MMSE),3个阳性对照研究采用蒙特利尔认知评测量表(MoCA),与对照组相比,丁苯酞能明显改善PSCI且差异有统计学意义。(3)5个阳性对照研究采用日常生活能力量表(ADL)评价显示,丁苯酞能明显改善PSCI病人的日常生活能力,差异有统计学意义。结论丁苯酞能明显改善卒中后病人认知功能障碍及日常生活能力,有效提高临床疗效。

Objective To assess the clinical curative effects of butylphthalide in the treatment of post-stroke cognitive impairment （PS-CI）.Methods We searched electronic database and relevant journals by manual searching,the randomized controlled trials （RCT） of butylphthalide in the treatment of PSCI were collected.The Cochrane Systematic Reviews of Interventions was used for statistical analysis. Results Eight trials involving 815 patients were included. Five positive controls,two blank controls,and one placebo-controlled trial were included. The Meta analysis of 3 studies in the evaluation of cognition suggested that butylphthalide can significantly improve PSCI,compared with the control group,and the difference was statistically significant.Meta analysis of 1studies using CDR and CIBIC score,6 studies using MMSE score,3 studies using MoCA score,according to the use of the scale respectively,suggested that cogni-tion improved of butylphthalide was better than the control group and the difference was statistically significant.Meta analysis of 5 studies using ADL score in the evaluation of activities of daily living,respectively suggested that butylphthalide can significantly im-prove patients of activities of daily living score,compared with the control group,and the difference was statistically significant. Conclu-sion Butylphthalide can can significantly improve the cognitive function and the activities of daily living in patients after stroke,and effectively improve clinical efficacy.