Xiao Liangyi, Tang Jie, Tan Huizhong, Xie Yao, Wang Shiliang, Xie Le, Wu Dahua
Graduate School, Hunan University of Chinese Medicine, Changsha, China.
Department of Acupuncture Rehabilitation, Changsha Hospital of Traditional Chinese Medicine, Changsha, China.
Front Pharmacol. 2024 Jul 3;15:1374482. doi: 10.3389/fphar.2024.1374482. eCollection 2024.
To conduct a meta-analysis of the effectiveness and safety of ginkgo biloba extract combined with donepezil hydrochloride vs. donepezil for the treatment of vascular dementia (VaD). Four English databases (PubMed, EMBASE, Web of Science, Cochrane Library) and four Chinese databases [the China National Knowledge Infrastructure Wanfang DATA, the Chongqing VIP Database (VIP), China Biomedical Database (CBM)] were manually searched for literature published from dates of the inception of the databases to September 2023. The randomized controlled trials (RCTs) of ginkgo biloba extract with donepezil hydrochloride vs. donepezil for the treatment of VaD were included. Relevant literature was screened, and the data in the included studies were extracted for quality assessment according to the Risk of bias tool. A total of 1,309 participants were enrolled in the 15 RCTs. Of these, 656 participants were in the experimental group (ginkgo biloba extract combined with donepezil) and 653 participants were in the control group (donepezil).The results showed that combination therapy was superior to donepezil alone, and there were statistically significant differences in several outcomes including RR in change for total effective rate (1.28, 95% confidence intervals 1.20, 1.38, < 0.001), MD in change for Mini-Mental State Examination score (2.98, 95%CI 2.31, 3.65, < 0.001), Barthel Index score (8.55,95%CI 1.11, 15.99, = 0.024), Activity of Daily Living Scale (ADL)score (10.11,95% CI 7.16,13.07, < 0.001). Ginkgo biloba extract combined with donepezil dramatically improved the total effective rate, MMSE, BI and ADL scores, and decreased homocysteine (HCY), plasma viscosity (PV), whole blood viscosity at high cut (BVH) and whole blood viscosity at low cut (BVL) in VaD patients, while the effect on mean flow velocity and pulse index (PI) of middle cerebral artery (MCA) is not obvious. However, more relevant high-quality RCTs are needed to validate these results. Identifier CRD42023474678.
对银杏叶提取物联合盐酸多奈哌齐与多奈哌齐治疗血管性痴呆（VaD）的有效性和安全性进行荟萃分析。手动检索了四个英文数据库（PubMed、EMBASE、Web of Science、Cochrane图书馆）和四个中文数据库[中国知网、万方数据、重庆维普数据库（VIP）、中国生物医学文献数据库（CBM）]，以查找从数据库创建日期至2023年9月发表的文献。纳入银杏叶提取物联合盐酸多奈哌齐与多奈哌齐治疗VaD的随机对照试验（RCT）。筛选相关文献，并根据偏倚风险工具提取纳入研究中的数据进行质量评估。15项RCT共纳入1309名参与者。其中，656名参与者在实验组（银杏叶提取物联合多奈哌齐），653名参与者在对照组（多奈哌齐）。结果表明，联合治疗优于单用多奈哌齐，在总有效率变化的RR（1.28，95%置信区间1.20，1.38，<0.001）、简易精神状态检查表评分变化的MD（2.98，95%CI 2.31，3.65，<0.001）、Barthel指数评分（8.55，95%CI 1.11，15.99，=0.024）、日常生活活动量表（ADL）评分（10.11，95%CI 7.16，13.07，<0.001）等多个结局指标上存在统计学显著差异。银杏叶提取物联合多奈哌齐显著提高了VaD患者的总有效率、MMSE、BI和ADL评分，并降低了同型半胱氨酸（HCY）、血浆黏度（PV）、高切全血黏度（BVH）和低切全血黏度（BVL），而对大脑中动脉（MCA）的平均血流速度和搏动指数（PI）的影响不明显。然而，需要更多相关的高质量RCT来验证这些结果。标识符CRD42023474678。
