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银杏叶提取物EGb 761针对不同类型痴呆症的疗效和耐受性:一项随机对照试验的分析

Efficacy and tolerability of Ginkgo biloba extract EGb 761 by type of dementia: analyses of a randomised controlled trial.

作者信息

Napryeyenko Oleksandr, Sonnik Grigoriy, Tartakovsky Igor

机构信息

Psychiatry, National Medical University, Kyiv City Clinical Psychoneurological Hospital No. 1, 103 A, Frunze Str., Kyiv 04080, Ukraine.

出版信息

J Neurol Sci. 2009 Aug 15;283(1-2):224-9. doi: 10.1016/j.jns.2009.02.353. Epub 2009 Mar 14.

Abstract

Secondary analyses of a randomised controlled trial were performed to find out whether treatment effects of Ginkgo biloba extract EGb 761 differed by type of dementia. Three hundred ninety-five patients aged 50 years or above, with dementia with neuropsychiatric features were treated with EGb 761 (240 mg/day) or placebo for 22 weeks. Patients scored between 9 and 23 on the Short Syndrome Test (SKT), a cross-culturally validated cognitive test battery. Their total score on the Neuropsychiatric Inventory (NPI) was at least 5. Efficacy was assessed by the SKT test battery (primary outcome measure), the Verbal Fluency Test, the Clock-Drawing Test, the NPI, the Hamilton Rating Scale for Depression (HAMD), and the Gottfries-Bråne-Steen Scale (GBS). Applying standard research diagnostic criteria 214 patients were diagnosed with Alzheimer's disease (probable AD or possible AD with cerebrovascular disease) and 181 with probable vascular dementia (VaD). Under EGb 761 treatment the SKT total score improved by -3.0+/-2.3 and -3.4+/-2.3 points in patients with AD and VaD, respectively, whereas the patients on placebo deteriorated by +1.2+/-2.5 and +1.5+/-2.2 points, respectively (p<0.01 for both drug-placebo differences). Significant drug-placebo differences were found for all secondary outcome variables with no major differences between AD and VaD subgroups. The rate of adverse events tended to be higher for the placebo group.

摘要

进行了一项随机对照试验的二次分析,以确定银杏叶提取物EGb 761的治疗效果是否因痴呆类型而异。395名年龄在50岁及以上、患有伴有神经精神症状的痴呆患者接受了EGb 761(240毫克/天)或安慰剂治疗22周。患者在经过跨文化验证的认知测试组合简易综合征测试(SKT)中的得分在9至23分之间。他们在神经精神科问卷(NPI)上的总分至少为5分。通过SKT测试组合(主要结局指标)、语言流畅性测试、画钟测试、NPI、汉密尔顿抑郁评定量表(HAMD)和戈特弗里斯-布劳内-斯滕量表(GBS)评估疗效。应用标准研究诊断标准,214名患者被诊断为阿尔茨海默病(可能的AD或伴有脑血管疾病的可能AD),181名患者被诊断为可能的血管性痴呆(VaD)。在EGb 761治疗下,AD患者和VaD患者的SKT总分分别提高了-3.0±2.3分和-3.4±2.3分,而服用安慰剂的患者分别恶化了+1.2±2.5分和+1.5±2.2分(两种药物与安慰剂的差异均p<0.01)。在所有次要结局变量中均发现了显著的药物与安慰剂差异,AD和VaD亚组之间无重大差异。安慰剂组不良事件的发生率往往更高。

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