胆碱酒石酸氢盐对成人认知功能障碍的作用：系统评价和荟萃分析。

BACKGROUND: Choline alphoscerate (alpha glyceryl phosphorylcholine, α-GPC) is a choline-containing phospholipid used as a medicine or nutraceutical to improve cognitive function impairment occurring in neurological conditions including adult-onset dementia disorders. Despite its 1985 marketing authorization, there are still discrepancies between countries regarding its approval as a prescription medicine and discussions about its effectiveness. OBJECTIVE: This study aimed to evaluate the efficacy of the α-GPC compound for treating cognitive impairment in patients with adult-onset neurological disorders. METHODS: Relevant studies were identified by searching PubMed, Web of Science, and Embase. Studies that evaluated the effects of α-GPC alone or in combination with other compounds on adult-onset cognitive impairment reporting cognition, function, and behavior were considered. We assessed the risk of bias of selected studies using the Cochrane risk of bias tool. RESULTS: A total of 1,326 studies and 300 full-text articles were screened. We included seven randomized controlled trials (RCTs) and one prospective cohort study that met our eligibility criteria. We found significant effects of α-GPC in combination with donepezil on cognition [4 RCTs, mean difference (MD):1.72, 95% confidence interval (CI): 0.20 to 3.25], functional outcomes [3 RCTs, MD:0.79, 95% CI: 0.34 to 1.23], and behavioral outcomes [4 RCTs; MD: -7.61, 95% CI: -10.31 to -4.91]. We also observed that patients who received α-GPC had significantly better cognition than those who received either placebo or other medications [MD: 3.50, 95% CI: 0.36 to 6.63]. CONCLUSION: α-GPC alone or in combination with donepezil improved cognition, behavior, and functional outcomes among patients with neurological conditions associated with cerebrovascular injury.

背景：胆碱磷酸甘油（α-甘油磷酸胆碱，α-GPC）是一种含胆碱的磷脂，被用作药物或营养保健品，以改善包括成人发病痴呆在内的神经疾病中发生的认知功能障碍。尽管它于 1985 年获得营销许可，但各国对其作为处方药的批准仍存在差异，并且对其疗效存在争议。

目的：本研究旨在评估 α-GPC 化合物治疗成人发病神经障碍患者认知障碍的疗效。

方法：通过检索 PubMed、Web of Science 和 Embase 来确定相关研究。评估了单独使用 α-GPC 或与其他化合物联合使用对报告认知、功能和行为的成人发病认知障碍的影响的研究。我们使用 Cochrane 偏倚风险工具评估了选定研究的偏倚风险。

结果：共筛选出 1326 项研究和 300 篇全文文章。我们纳入了 7 项随机对照试验（RCT）和 1 项符合入选标准的前瞻性队列研究。我们发现 α-GPC 联合多奈哌齐对认知有显著影响[4 项 RCT，平均差（MD）：1.72，95%置信区间（CI）：0.20 至 3.25]，对功能结局有显著影响[3 项 RCT，MD：0.79，95%CI：0.34 至 1.23]，对行为结局有显著影响[4 项 RCT；MD：-7.61，95%CI：-10.31 至-4.91]。我们还发现，接受 α-GPC 的患者认知能力明显优于接受安慰剂或其他药物的患者[MD：3.50，95%CI：0.36 至 6.63]。

结论：α-GPC 单独或与多奈哌齐联合使用可改善与脑血管损伤相关的神经疾病患者的认知、行为和功能结局。