摘要:
Objective To systematically evaluate the efficacy and safety of oral preparation of ginkgo biloba in treating vascular dementia (VD).Methods A fully literature search was conducted in CNKI,Wanfang,Sinomed,VIP databases,PubMed,Embase,the Cochrane Library and Clinical Trails with the deadline of October,2018 for randomly controlled trials of oral preparation of ginkgo biloba for vascular dementia.After assessing the quality of literatures included,RevMan5.3 software was used to analyze the extracted data.Results A total of 17 studies which including 1 326 patients were involved.The results of meta-analysis showed that:compared with the western medicine group,oral ginkgo biloba preparation combined with western medicine group was much better in the MMSE assessment [MD=2.89,95% CI (2.06,-3.72),P=0.000 1],there was no significant difference between the western medicine group and the pure oral ginkgo biloba group in the ADL assessment [MD=-3.00,95% CI (-4.69,-1.30),P=0.000 5] and overall clinical status assessment [RR=1.29,95% CI (1.20,1.39),P<0.000 01],the efficacy of the pure oral ginkgo biloba group and western medicine group was similar in the ADL assessment [MD=-0.93,95% CI (-3.48,1.63),P=0.48].Conclusions Based on the meta-analysis,oral preparation of ginkgo biloba combinedwithwestemmedicinehas certain advantages compared with conventional western medicine treatment alone,but a large number of large-sample and high-quality trials are requiredtofurther prove and review its effect%目的 系统评价银杏叶口服制剂治疗血管性痴呆(vascular dementia,VD)的疗效及安全性.方法 检索中国期刊全文数据库(CNKI)、中国学术期刊数据库(万方数据)、中国生物医学文献服务系统(SinoMed)、中文科技期刊数据库(重庆维普)、PubMed数据库、EMBASE、Cochrane Library及Clinical Trails建库至2018年10月,有关银杏叶口服制剂治疗VD的RCT文献.按照Cochrane协作网推荐方法对纳入文献进行评价及资料提取,采用RevMan 5.3软件进行meta分析.结果 共纳入文献17篇,meta分析结果显示,银杏叶口服制剂联合西药治疗在改善VD患者认知能力(简易精神状态检查评分)[MD=2.89,95% CI(2.06~-3.72),P=0.000 1]与日常生活能力(日常生活能力量表评分)[MD=-3.00,95% CI(-4.69~-1.30),P=0.000 5]方面效果优于单纯西药治疗;单纯口服银杏叶制剂与单纯西药疗效比较,差异无统计学意义[MD=-0.93,95% CI(-3.48~1.63),P=0.48];口服银杏叶制剂联合西药治疗VD总有效率优于单纯西药[RR=1.29,95% CI(1.20~1.39),P<0.000 01].结论 口服银杏叶制剂联合西药治疗VD较常规西药治疗具有一定优势,但仍需大量大样本、高质量的研究支持结论.