丁苯酞软胶囊治疗帕金森病及相关并发症有效性的Meta分析

Efficacy of Butylphthalide for Parkinson's Disease and Related Complications:a Meta-analysis

目的系统评价丁苯酞软胶囊治疗帕金森病及其相关并发症的临床有效性。方法通过检索中国知网(CNKI)、维普、万方、中国生物医学文献数据库(CBM)及PubMed数据库,收集丁苯酞软胶囊治疗帕金森病及其相关并发症的随机对照试验(RCT),检索时限为建库至2019年6月。由两名评价员独立筛选文献、提取资料并对纳入研究的偏倚风险进行评价。采用RevMan5.3软件进行Meta分析。结果共纳入15项RCT,累计病人1174例。Meta分析结果显示,治疗组统一帕金森病评分量表评分[MD=-10.13,95%CI(-11.62,-8.65),P<0.00001]、汉密尔顿抑郁量表评分[MD=-5.13,95%CI(-6.56,-3.71),P<0.00001]明显低于对照组,蒙特利尔认知评估量表评分[MD=3.33,95%CI(2.68,3.99),P<0.00001]、日常生活活动能力量表评分[MD=12.87,95%CI(11.06,14.69),P<0.00001]和简易智力状态检查量表评分[MD=3.26,95%CI(2.44,4.08),P<0.00001]明显高于对照组。在血清学方面,治疗组C反应蛋白[MD=-2.40,95%CI(-2.63,-2.16),P<0.00001]、帕金森病蛋白7[MD=-10.63,95%CI(-11.97,-9.29),P<0.00001]明显低于对照组,血清神经生长因子-3[MD=8.12,95%CI(7.34,8.91),P<0.00001]水平明显高于对照组。结论现有证据表明,丁苯酞软胶囊可明显改善帕金森病病人症状及相关并发症,改善认知功能障碍及抑郁状态。

Objective To evaluate the efficacy of Butylphthalide for Parkinson's disease(PD)and related complications.Methods Randomized controlled trials(RCT)on Butylphthalide for PD and related complications were collected from CNKI,Wanfang,VIP,CBM,and PubMed,the retrieval time was from inception to June,2019.The literature selection,data collection,and evaluation of bias were conducted by two researchers independently.Meta-analysis was performed by RevMan 5.3 software.Results A total of 15 RCT involving 1174 patients were included.Compared with control group,Butylphthalide could significantly reduce UPDRS score[MD=-10.13,95%CI(-11.62,-8.65),P<0.00001]and HAMD score[MD=-5.13,95%CI(-6.56,-3.71),P<0.00001],increase MoCA score[MD=3.33,95%CI(2.68,3.99),P=0.79],ADL score[MD=12.87,95%CI(11.06,14.69),P<0.00001],and MMSE score[MD=3.26,95%CI(2.44,4.08),P<0.00001];Butylphthalide could significantly reduce the levels of CRP[MD=-2.40,95%CI(-2.63,-2.16),P<0.00001]and PARK7[MD=-10.63,95%CI(-11.97,-9.29),P<0.00001],increase the level of NT-3[MD=8.12,95%CI(7.34,8.91),P<0.00001].Conclusion Curren evidence showed that Butylphthalide could significantly improve the symptoms and related complications of PD,cognitive dysfunction,and depression.