奥拉西坦治疗脑出血后认知障碍的效果及安全性的meta分析  

Meta-analysis of the efficacy and safety of Oxiracetam in the treatment of cognitive impairment after intracerebral hemorrhage

作　　者：薛道金 尹莲君 孟锦园 甄政 詹杰 沈有碧 彭子壮 黄涛 XUE Daojin;YIN Lianjun;MENG Jinyuan;ZHEN Zheng;ZHAN Jie;SHEN Youbi;PENG Zizhuang;HUANG Tao(Department of Neurosurgery,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou 510370,China;the Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第二附属医院神经外科,广东广州510370 [2]广州中医药大学第二临床医学院,广东广州510405

出　　处：《中国医药导报》2021年第29期77-81,共5页China Medical Herald

基　　金：广东省中医药局科研项目(20181111)。

摘　　要：目的系统评价奥拉西坦治疗脑出血后认知障碍的效果及安全性。方法计算机检索CNKI、Wanfang Data、VIP、CBM、Embase、PubMed、the Cochrane Library数据库中有关奥拉西坦治疗脑出血后认知障碍的随机对照试验,检索时限从建库至2020年11月。采用RevMan 5.3软件进行meta分析。结果纳入8篇文献共计616例患者,试验组310例,对照组306例。meta分析结果显示:试验组简易精神状态检查(MMSE)评分(MD=8.85,95%CI:4.82~12.87,P<0.0001)、Barthel指数(MD=17.21,95%CI:15.29~19.14,P<0.0001)均高于对照组。进一步进行亚组分析显示:静滴组MMSE评分(MD=12.33,95%CI:8.54~16.11,P<0.00001)、Barthel指数(MD=20.44,95%CI:17.77~23.11,P<0.00001)和口服组MMSE评分(MD=4.19,95%CI:2.20~6.18,P<0.0001)、Barthel指数(MD=13.73,95%CI:10.95~16.50,P<0.00001)均高于对照组。试验组长谷川痴呆量表评分高于对照组(MD=3.84,95%CI:1.65~6.03,P=0.0006),美国国立卫生研究院卒中量表评分低于对照组(MD=-4.31,95%CI:-6.37~-2.25,P<0.0001)。两组不良反应发生率比较,差异无统计学意义(RR=1.18,95%CI:0.62~2.22,P=0.62)。结论奥拉西坦在改善脑出血患者认知功能、日常生活活动能力、神经功能缺损症状方面具有显著疗效。Objective To systematically evaluate the efficacy and safety of Oxiracetam in the treatment of cognitive impairment after intracerebral hemorrhage.Methods Randomized controlled trials of Oxiracetam for cognitive impairment after intracerebral hemorrhage were searched in CNKI,Wanfang Data,VIP,CBM,EMbase,PubMed,and the Cochrane Library.The retrieval period is from inception to November 2020.Meta-analysis was performed using RevMan 5.3 software.Results A total of 616 patients were included in eight literatures,310 in experimental group and 306 in control group.The mini mental status examination(MMSE) score(MD = 8.85,95% CI:4.82-12.87,P < 0.0001) and Barthel index(MD = 17.21,95%CI:15.29-19.14,P < 0.0001) in experimental group were higher than those in control group.Further subgroup analysis showed that the MMSE score(MD = 12.33,95%CI:8.54-16.11,P < 0.000 01) and Barthel index(MD = 20.44,95%CI:17.77-23.11,P < 0.000 01) of static drops group,the MMSE score(MD = 4.19,95%CI:2.20-6.18,P < 0.0001),and Barthel index(MD = 13.73,95%CI:10.95-16.50,P < 0.000 01) of oral group were higher than those in control group.Hasegawa dementia scale score in the experimental group was higher than that in the control group(MD = 3.84,95%CI:1.65-6.03,P = 0.0006),and National Institutes of Health stroke scale score was lower than that in the control group(MD =-4.31,95%CI:-6.37 to-2.25,P < 0.0001).There was no significant difference in the incidence of adverse reactions between the two groups(RR = 1.18,95% CI:0.62-2.22,P = 0.62).Conclusion Oxiracetam has significant effect in improving cognitive function,activities of daily living and neurological deficit symptoms of patients with intracerebral hemorrhage.

关 键 词：奥拉西坦 脑出血 认知障碍 META分析 随机对照试验 

分 类 号：R743[医药卫生—神经病学与精神病学]