丁苯酞序贯治疗对脑卒中后认知功能障碍患者疗效及安全性的Meta分析  

Meta analysis of efficacy and safety of sequential treatment of butylphthalein in patients with cognitive impairment after stroke

作　　者：代敏慧 祝凯 张钰华[1] 刘忠和 熊小平 张艳芳 DAI Minhui;ZHU Kai;ZHANG Yuhua;LIU Zhonghe;XIONG Xiaoping;ZHANG Yanfang(Medical College of Jishou University,Jishou,Hunan 416000,China;Department of Gastroenterology,Qianjiang Central Hospital of Chongqing,Chongqing 409000,China;Department of Neurology,Qianjiang Central Hospital of Chongqing,Chongqing 409000,China;Department of Science and Education,Qianjiang Central Hospital of Chongqing,Chongqing 409000,China)

机构地区：[1]吉首大学医学院,湖南吉首416000 [2]重庆市黔江中心医院消化内科,重庆409000 [3]重庆市黔江中心医院神经内科,重庆409000 [4]重庆市黔江中心医院科教科,重庆409000

出　　处：《检验医学与临床》2023年第20期2963-2968,共6页Laboratory Medicine and Clinic

基　　金：吉首大学研究生科研创新项目(JYG2022081);重庆市黔江区科技计划项目(20220001)。

摘　　要：目的系统评价丁苯酞序贯治疗对脑卒中后认知功能障碍患者的疗效及安全性。方法全面检索2000年1月1日至2022年10月8日已发表的丁苯酞序贯治疗急性缺血性脑卒中后认知功能障碍患者的相关文献。检索数据库包括中国知网、万方数据库、中国生物医学文献服务系统、PubMed、Cochrane图书馆、EMBASE数据库,以及中国临床试验注册中心和美国临床试验注册中心。由2位研究者完成文献筛选、资料收集及文献偏倚风险评价后,提取结局指标。采用Review Manager 5.3软件进行数据分析。结果有12项共1087例诊断为脑卒中后认知功能障碍患者的随机对照临床试验纳入该研究。Meta分析结果显示,治疗组在临床疗效(RR=1.27,95%CI:1.19~1.35,P<0.05)、蒙特利尔认知评估评分[加权均数差(WMD)=3.45,95%CI:3.11~3.79,P<0.05]、简易智能精神状态检查量表(WMD=2.94,95%CI:0.50~5.38,P<0.05)、美国国立卫生研究院卒中量表评分(WMD=-2.19,95%CI:-3.25~-1.14,P<0.05)、Barthel指数(WMD=11.65,95%CI:11.21~12.09,P<0.05)、日常生活活动量表评分(WMD=17.92,95%CI:16.00~19.85,P<0.05)方面与对照组比较,差异均有统计学意义。两组不良反应比较,差异无统计学意义(RR=1.04,95%CI:0.58~1.86,P>0.05)。结论丁苯酞序贯治疗可明显改善脑卒中后认知障碍患者的认知功能、神经功能缺损情况,以及提高日常生活能力,且安全性较好。Objective To evaluate the efficacy and safety of butylphthalide sequential treatment in patients with cognitive impairment after stroke.Methods A comprehensive search was conducted for the literature published from January 1,2000 to October 8,2022 on the sequential treatment of butylphthalide in patients with cognitive impairment after acute ischemic stroke.The databases included China National Knowledge Infrastructure(CNKI),Wanfang database,Sinomed,PubMed,Cochrane Library,EMBASE database,and Clinical Trial registries of China and the United States were searched.After literature screening,data collection and risk of bias assessment were completed by 2 researchers,the outcome indicators were extracted.Review Manager 5.3 software was used for data analysis.Results A total of 12 RCTS involving 1087 patients with cognitive impairment after stroke were included in the study.Meta analysis showed that butylphthalide sequential treatment group had better clinical efficacy(RR=1.27,95%CI:1.19-1.35,P<0.05),Montreal cognitive assessment score[weighted mean difference(WMD=3.45,95%CI:3.11-3.79,P<0.05],Mini-Mental State Examination score(WMD=2.94,95%CI:0.50-5.38,P<0.05),National Institutes of Health Stroke Scale score(WMD=-2.19,95%CI:-3.25--1.14,P<0.05),Barthel index(WMD=11.65,95%CI:11.21-12.09,P<0.05),activities of daily living scale score(WMD=17.92,95%CI:16.00-19.85,P<0.05).There was no significant difference in adverse reactions between the 2 groups(RR=1.04,95%CI:0.58-1.86,P>0.05).Conclusion Butylphthalide sequential treatment can significantly improve the cognitive function,neurological function and activities of daily living in patients with cognitive impairment after stroke,and it is safe.

关 键 词：丁苯酞序贯治疗 脑卒中 认知功能障碍 META分析 

分 类 号：R743[医药卫生—神经病学与精神病学]