奥拉西坦治疗卒中后认知功能障碍的Meta分析

摘要

目的 评价奥拉西坦治疗卒中后认知功能障碍病人的临床疗效.方法 应用计算机检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(CSTJ)、中国生物医学文献数据库(CBM)、万方数据库(WanFang database),并手工查阅其他检索工具.对符合纳入标准的奥拉西坦治疗卒中后认知功能障碍病人的随机对照临床研究文献,采用Meta分析进行系统评价.结果 纳入单个临床研究文献15篇,总例数1 780例.Meta分析显示:奥拉西坦治疗卒中后认知功能障碍的总有效率为89.8%,对照组为71.5%,差异有统计学意义[OR=3.57,95%CI(2.49~5.11),P<0.01],简易智能精神状态量表(MMSE)积分与对照组比较,差异有统计学意义[MD =4.02,95%CI(2.62~5.42),P<0.01],日常生活活动能力量表(ADL)积分与对照组比较,差异有统计学意义[MD =4.23,95%CI(1.64~6.81),P<0.01],不良反应与对照组比较差异无统计学意义[OR=0.73,95%CI(0.37~1.47),P>0.05].结论 奥拉西坦在临床疗效、认知功能和日常生活能力等方面优于吡拉西坦、茴拉西坦、尼莫地平及单纯常规治疗,且安全性较好.%Objective To evaluate the clinical curative effects of oxiracetam in the treatment of congnition impairment after stroke.Methods Chinese National Knowledge Infrastructure (CNKI),China Science and Technology Journal database (CSTJ),China Biological Medicine database (CBM),WanFang database were searched by computer and other retrival tools were looked up by handwork.Clinical documents accorded with sdandard of oxiracetam treating congnition impairment after stroke were evaluated by meta analysis.Results One thousand,seven hundreds and eighty cases of 15 single clinical literature were by meta analysis which showed total curative effects of treating group and control group were respectively 89.8% and 71.5% which were of statistical significance(OR=3.57,95% CI:2.49 to 5.11,P<0.01),Comparision of both groups in MMSE integrals and ADL integrals were of statistical significance respectively (MD=4.02,95% CI:2.62 to 5.42,P<0.01) and (MD =4.23,95% CI:1.64 to 6.81,P<0.01).Adverse reactions of both groups were not of statistical significance (OR=0.73,95% CI:0.37 to 1.47,P>0.05).Conclusion Oxiracetam is better than alone piracetam,nimodipine,aniracetam and conventional treatment alone in improving clinical curative effect,congnitive function,activity daily living and has good safety.