认知促进治疗对于老年性痴呆患者治疗效果的meta分析

目的:系统评价认知促进治疗(CST)对老年性痴呆患者的治疗效果,为临床实践提供依据。方法:检索外文数据库PubMed、Embase、Cochrane library及中文数据库知网、维普和万方数据库中建库至2019年6月间采用随机对照研究(RCT)设计的CST对于老年性痴呆患者治疗效果的文献,采用Cochrane风险偏倚评估工具进行文献质量评价后,使用ReVMan5.3软件进行meta分析。结果:共纳入9篇研究,合计样本量684人。2篇文献仅以阿尔茨海默病评估量表-认知分表(ADAS-Cog)评分为效果评价指标,3篇文献仅以简易智力状态检查量表(MMSE)评分为效果评价指标,其余4篇采用了上述两种评价指标。以ADAS-Cog评分为效果评价指标的meta分析结果显示,CST与对照组均显示有改善效果,但差异无统计学意义(SMD=0.02,Z=0.22,P>0.05)。以MMSE评分为效果评价指标的meta分析结果显示,CST对老年性痴呆的认知功能改善优于对照组(SMD=0.47,Z=2.73,P<0.01)。结论:CST可以在一定程度上改善老年性痴呆患者的认知功能,但需要在大样本研究以及发展中国家中进一步验证。

A meta-analysis of effect of cognitive stimulation theapy for patients with senile dementia

Objective:To evaluate the efficacy of cognitive stimulation therapy(CST)for senile dementia patients based on a meta-analysis from randomized controlled trials(RCT),so as to provide evidence for clinical treatment.Methods:Papers related to randomized controlled trials on CST were searched from Pubmed,Embase,Cochrane library,CNKI,VIP,and Wanfang from construction to June 2019.Cochrane method was used to evaluate the quality of papers which met the inclusion criteria.Data were analyzed using RevMan5.3.Results:Nine studies including 684 subjects were analyzed.The effect in two studies was evaluated by the score of Alzheimer’s disease assessment scale(ADAS-Cog)only,while in 3 studies,the effect was accessed by the score of Mini-mental State Examination(MMSE)only.The rest of 4 studies,both ADAS-cog and MMSE were used to evaluate the effect.The ADAS-Cog score of both CST group and the control group had improved effects,but the difference between the two groups had no statistical difference(SMD=0.02,Z=0.22,P>0.05).For the MMSE score,it was showed that cognitive function of CST group was improved compared with control group(SMD=0.47,Z=2.73,P<0.01).Conclusion:Findings from the study show that CST can improve the cognitive function of senile dementia patients.However,further researches based on large samples are needed,especially from developing countries.