目的：系统评价尼莫地平联合吡拉西坦对比尼莫地平治疗脑梗死后血管性痴呆的疗效与安全性。方法检索自2000年1月~2016年1月期间维普期刊全文数据库（VIP）、中国学术期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、中国生物医学期刊引文数据库（CMCI）、web of science （SCI）、PubMed、Springerlink等数据库内关于脑梗死后血管性痴呆的随机对照试验（RCT），用改良后的Jadad量表进行评价并提取资料，然后运用Review Manager 5.3软件及Stata软件对纳入文献进行系统评价。结果最终纳入5篇RCT，共346例患者，其中172例给予尼莫地平（对照组），172例给予尼莫地平和吡拉西坦联合治疗（观察组）。 Meta结果显示，与对照组比较，观察组经6个月治疗后，MMSE评分增高（95%CI：4.40~5.82，Z=14.12，P<0.00001）；ADL评分降低（95%CI：-13.00~-7.29，Z=6.96，P<0.00001），且不良反应增加比较差异无统计学意义（P>0.05）。结论尼莫地平联合吡拉西坦治疗脑梗死后血管性痴呆疗效优于单用尼莫地平，不良反应无明显增加。%Objective To evaluate therapeutic efficacy and safety of nimodipine combined with piracetam vs nimodip-ine in the treatment of vascular dementia after cerebral infarction. Methods By searching the randomized controlled tri-al (RCT) about vascular dementia after cerebral infarction from VIP, CNKI, CBM, CMCI, SCI, PubMed, Springerlink database from January 2000 to January 2016. Review Manager 5.3 software and Stata software was used to extract the data after evaluating the quality of documents by modified Jadad scale and conducting Meta-analysis. Results 5 RCT was included, involving 346 patients, of which 172 patients were treated with nimodipine (the observation group), the others was treated with nimodipine combined with piracetam (the control group). Meta-analysis showed that nimodipine combined piracetam increased MMSE score (95%CI4.40-5.82,Z=14.12,P< 0.000 01), reduced ADL score [95%CI(-13.00,-7.29),Z=6.96,P<0.000 01];at the same time, there was no significant increase in the incidence of adverse reactions between the two groups after six months (P> 0.05). Conclusion The efficacy of nimodipine combined with piracetam is better than sole using nimodipine and there is no significant increase in the incidence of adverse reactions between the two groups .
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