Xu Jing, Wang Li-Ling, Dammer Eric B, Li Chun-Bo, Xu Gang, Chen Sheng-Di, Wang Gang
Department of Neurology & Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Am J Alzheimers Dis Other Demen. 2015 Aug;30(5):439-47. doi: 10.1177/1533317514568005.
The current review aims to examine melatonin therapy for both sleep disturbances and cognitive function in dementia. We searched all randomized controlled trials published in Medline, Embase, the Cochrane Library, China National Knowledge Infrastructure, the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register, and Clinical Trials.gov. The grading of recommendations assessment, development and evaluation framework was used to assess the quality of evidence. Seven studies were included (n = 520). Treated participants showed prolonged total sleep time (TST) by 24.36 minutes (P = .02). Sleep efficacy (SE) was marginally improved (P = .07). This effect was stronger under a longer intervention period lasting more than 4 weeks (P = .02). Conversely, cognitive function did not change significantly. Additionally, there was no report of severe adverse events. Given the current studies, we conclude that melatonin therapy may be effective in improving SE and prolonging TST in patients with dementia; however, there is no evidence that this improvement impacts cognitive function.
本综述旨在探讨褪黑素疗法对痴呆症患者睡眠障碍和认知功能的影响。我们检索了发表在Medline、Embase、Cochrane图书馆、中国知网、Cochrane痴呆与认知改善小组专业注册库以及ClinicalTrials.gov上的所有随机对照试验。采用推荐意见评估、制定与评价框架对证据质量进行评估。纳入了7项研究（n = 520）。接受治疗的参与者总睡眠时间（TST）延长了24.36分钟（P = .02）。睡眠效率（SE）略有改善（P = .07）。在持续超过4周的较长干预期下，这种效果更强（P = .02）。相反，认知功能没有显著变化。此外，没有严重不良事件的报告。基于目前的研究，我们得出结论，褪黑素疗法可能对改善痴呆症患者的SE和延长TST有效；然而，没有证据表明这种改善会影响认知功能。
