Department of Special-needed Medical, Chengdu BOE Hospital, Chengdu, Sichuan Province, China.
Department of Neurology, The Air Force Hospital of Western Theater Command, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2022 Aug 5;101(31):e29642. doi: 10.1097/MD.0000000000029642.
Current research has found contradictory results on the treatment of magnesium valproate (VPM) in patients with dementia (PwD).
Here, we conducted a meta-analysis to evaluate the efficacy and safety of VPM in the adjuvant treatment of PwD.
Current research has found contradictory results on the treatment of VPM in PwD. Here, we conducted a meta-analysis to evaluate the efficacy and safety of VPM in the adjuvant treatment of PwD.
MEDLINE via PubMed, Cochrane Library, EBSCO, Embase, China National Knowledge (CNKI), and Wan Fang databases were researched to gather relevant data on magnesium valproate assistant therapy for patients with dementia (PwD) by using medical subject headings and term words.
After the final screening, 22 RCT studies (a total of 1899 participants) were included in this meta-analysis, which compared VPM adjuvant treatment with antidementia or psychotropic drug monotherapy. Significant differences were found in the scores on mini-mental state examination (P = .028), Alzheimer disease assessment scale cognitive subscale (P < .05), Bech-Rafaelsen Mania Rating Scale (P < .05), behavioral pathology in Alzheimer disease rating scale (P = .001), activities of daily living (P < .05), and Pittsburgh Sleep Quality Index (P < .05). Besides, the levels of inflammatory factors including IL-1β, IL-6, and TNF-α were significantly lower than those in the monotherapy group (P < .05). While there was no increase in the incidence of adverse events (P = .383), VPM as an assistant therapy is generally well tolerated in PwD.
By meta-analysis, evidence was found to support VPM additional used for the treatment of cognitive function, psychiatric symptoms, or disease improvement in PwD. VPM may be a potential drug to aid in the treatment of dementia patients. However, there was lack of enough evidence to classification of dementia severity in our inclusion study. More research is still needed, including clinical trials evaluating VPM as a complementary therapy.
目前的研究在镁丙戊酸（VPM）治疗痴呆患者（PwD）方面得出了相互矛盾的结果。
本研究通过荟萃分析评估 VPM 在辅助治疗 PwD 中的疗效和安全性。
通过 MEDLINE 中的 PubMed、Cochrane 图书馆、EBSCO、Embase、中国国家知识基础设施（CNKI）和万方数据库，使用医学主题词和术语搜索与镁丙戊酸辅助治疗痴呆患者相关的数据。
最终筛选后，本荟萃分析纳入了 22 项随机对照试验研究（共 1899 名参与者），比较了 VPM 辅助治疗与抗痴呆或精神药物单药治疗。在简易精神状态检查评分（P =.028）、阿尔茨海默病评估量表认知分量表（P <.05）、Bech-Rafaelsen 躁狂评定量表（P <.05）、阿尔茨海默病行为病理评定量表（P =.001）、日常生活活动能力（P <.05）和匹兹堡睡眠质量指数（P <.05）方面，VPM 辅助治疗组的评分差异有统计学意义。此外，白细胞介素-1β、白细胞介素-6 和肿瘤坏死因子-α等炎症因子水平明显低于单药治疗组（P <.05）。虽然不良反应发生率没有增加（P =.383），但 VPM 作为辅助治疗在 PwD 中总体耐受性良好。
荟萃分析结果支持 VPM 可额外用于改善 PwD 的认知功能、精神症状或疾病。VPM 可能是治疗痴呆患者的一种潜在药物。然而，我们纳入的研究缺乏足够的证据来对痴呆严重程度进行分类。还需要更多的研究，包括评估 VPM 作为补充治疗的临床试验。
