多奈哌齐治疗阿尔茨海默病的系统评价

目的 Meta分析评价多奈哌齐治疗阿尔茨海默病(AD)的临床疗效和安全性。方法计算机检索Medline、EMBASE、Ovid、CNKI及万方数据库。以AD患者服用多奈哌齐5mg和10mg口服干预12~30周为标准,以安慰剂为对照,选取自各数据库建库至2013年9月,筛选符合纳入标准的所有文献,并进行Meta分析。结果共检索到198篇相关文献,9篇随机对照试验文献符合纳入标准,AD患者共3064例。多奈哌齐对AD患者总体功能评价的改善效果均优于安慰剂(OR=1.86,95%CI:1.56~2.21,P<0.01)。与5mg治疗比较,多奈哌齐10mg治疗对AD患者总体功能评价的改善效果差异无统计学意义(OR=0.91,95%CI:0.72~1.15,P=0.43)。多奈哌齐的严重不良事件发生率与安慰剂比较,差异无统计学意义(OR=1.04,95%CI:0.88~1.24,P=0.65)。多奈哌齐5mg、10mg治疗AD的严重不良事件发生率比较,差异无统计学意义(OR=0.70,95%CI:0.47~1.04,P=0.08)。结论多奈哌齐可显著改善AD患者的总体功能评价,安全性好,但疗效并不存在剂量依赖性。但限于纳入的研究文献较少及疗法学质量上的局限,本系统评价结果尚需更多高质量的随机对照试验进一步验证。

Systematic assessment of donepezil in treatment of Alzhemier's disease

Objective To assess the efectiveness and safety of donepezil in treatment of Alzhemier's disease(AD)by meta analysis.Methods Papers on donepezil in treatment of AD were retrieved from MEDLINE,EMBASE,Ovid,CNKI and Wanfang.The AD patients received oral donepezil at the dose of 5mg and 10 mg for 12-30 weeks.The papers meeting the inclusion criteria in this study were analyzed by meta analysis.Results Of the 198 papers involving 3064 AD patients on donepezil treatment,9on RCT met the inclusion criteria in this study.The effect of donepezil was better than that of placebo on the general function of AD patients(OR=1.86,95%CI:1.56-2.21,P<0.01).No significant difference was found in the effect of 5mg and 10 mg donepezil on the general function,in the severe adverse events of donepezil and placebo,and of 5mg and 10 mg donepezil(OR=0.91,95%CI:0.72-1.15,P=0.43;OR=1.04,95%CI:0.88-1.24,P=0.65;OR=0.70,95%CI:0.47-1.04,P=0.08).Conclusion Donepezil can significantly improve the general function of AD patients with a good safety.However,its therapeutic effect is not dose-dependent.More CRT are thus needed to verify our conclusion due to the limited studies and therapeutic methods included in this study.