美金刚对比多奈哌齐治疗帕金森病痴呆的Meta分析  

Meta-analysis of memantine versus donepezil in treatment of Parkinson’s disease dementia

作　　者：胡一斌 张立娟[2] 马屹峥 毕淑月 侯翰如 李明襄 刘长宁 王康锋[4] HU Yibin;ZHANG Lijuan;MA Yizheng;BI Shuyue;HOU Hanru;LI Mingxiang;LIU Changning;WANG Kangfeng(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250013,China;Department of Clinical Education Management,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China;First College of Clinical Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250199,China;Department of Neurology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)

机构地区：[1]山东中医药大学中医学院,山东济南250013 [2]山东中医药大学附属医院临床教育管理科,山东济南250011 [3]山东中医药大学第一临床医学院,山东济南250199 [4]山东中医药大学附属医院神经内科,山东济南250011

出　　处：《药物评价研究》2022年第12期2564-2573,共10页Drug Evaluation Research

基　　金：国家自然科学基金青年基金资助项目(81303028);山东省中医药科技发展计划资助项目(2019-0107,2019-0094);山东省科技发展计划资助项目(2014GSF119038);济南市科技发展计划(202019027,202134007);山东中医药大学附属医院首批青年科研创新团队项目。

摘　　要：目的 系统评价美金刚对比多奈哌齐治疗帕金森病痴呆的疗效与安全性。方法 检索中国学术期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、维普中文期刊全文数据库(VIP)和中国生物医学文献数据库(SinoMed)、Cochrane Library、PubMed、Web of Science等数据库自建库起至2022年7月1日收录的有关美金刚、多奈哌齐分别联合多巴丝肼治疗帕金森病痴呆的临床随机对照试验(RCT)。评估偏倚风险,并收集患者治疗后的简易精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分变化情况,临床总有效率及不良反应发生率,采用RevMan 5.3软件进行Meta分析。结果 共纳入14项RCTs,总计1 219名患者,其中美金刚联合多巴丝肼组610例、多奈哌齐联合多巴丝肼组609例。Meta分析结果显示,美金刚联合多巴丝肼在改善MMSE评分、改善MoCA评分、提高临床总有效率方面效果均优于多奈哌齐联合多巴丝肼,其差异有统计学意义(P<0.05);美金刚对比多奈哌齐治疗帕金森病痴呆的不良反应发生率更低。结论美金刚对帕金森病痴呆患者的认知功能改善效果优于多奈哌齐,临床总有效率更高,且治疗后不良反应发生率低。Objective To systematically evaluate and compare the efficacy and safety of memantine and donepezil in the treatment of Parkinson’s disease dementia.Methods CNKI,Wanfang,VIP,SinoMed,Cochrane Library,PubMed,Web of Science were selected to search the randomized controlled trials(RCT) of memantine and donepezil combined with madopar respectively in the treatment of Parkinson’s disease dementia,from the date of establishment to July 1,2022.The risk of bias was evaluated,and the changes in MMSE score,MoCA score,total clinical efficiency rate,and adverse reaction rate after treatment were collected.RevMan 5.3software was used for Meta-analysis.Results A total of 1 219 patients were enrolled in 14 RCTs,including 610 patients in the combination of memantine and madopar group and 609 patients in the combination of donepezil and madopar group.Meta-analysis results showed that memantine combined with madopar was superior to donepezil combined with madopar in improving MMSE score,MoCA score,and clinical total effective rate,with a statistically significant difference(P < 0.05).The adverse reaction rate of memantine combined with donepezil in the treatment of Parkinson’s disease dementia was lower.Conclusion Memantine was superior to donepezil in improving the cognitive function of patients with Parkinson’s disease dementia,with a higher clinical total effective rate and lower incidence of adverse reactions after treatment.

关 键 词：美金刚 多奈哌齐 多巴丝肼 帕金森病痴呆 META分析 

分 类 号：R969.3[医药卫生—药理学] R971[医药卫生—药学]