Efficacy Of Butyl Phthalide Combined With Donepezil For Vascular Dementia:a Systematic Review

Background:Vascular dementia is the second most common type of dementia,accounting for 17 to 25 percent of all dementia cases worldwide.^[1]Common symptoms of cognitive decline include memory,cognition,language,reasoning,execution,and learning.Although the exact pathogenesis of VaD is unclear,but on the basis of the evidence seems to indicate that reported so far,it may be caused by a variety of reasons,includingcausedbycerebrovasculardiseaseriskfactorsand cerebrovasculardisease,suchasage,hypertension,diabetes,hyperlipidemia,high homocysteine hematic disease,atherosclerosis and stroke.Current research shows that 25-30%of patients with ischemic stroke have immediate or delayed vascular cognitive impairment or vascular dementia.^[2]Donepezil is a cholinesterase inhibitor,which is a classic drug for improving dementia.Butylphthalein is a new drug developed independently in China.In recent years,basic experimental reports have positive effects on the hippocampus of mice and improves cognitive function.However,only a small number of trials have been conducted to study the efficacy of these two drugs combined to improve the treatment of patients with vascular dementia.Objective:The purpose of this paper is to evaluate the therapeutic effect of butylphthalein combined with donepezil in the treatment of vascular dementia,and to provide a better treatment plan for vascular dementia.Methods:Computer retrieval（Cochrance Library,Pubmed,CNKI,VIP,WANGFANG）database,such as collection of butyl phthalide joint donnelly,pp’s treatment of vascular dementia related literature,and on the basis of the formulation of filtered into and exclusion criteria,the final qualified RevMan5.3 literature used for data analysis.Results:Nine studies（804 patients）were included in this study.In 8studies（684 patients）,MMSE score was used to evaluate the improvement of dementia in patients.Meta analysis shows that butylphthalein group are superior to the control group:[MD=3.61,95%CI（3.50,3.71）,P<0.05,I²=0];Four studies（415 cases）were given clinical efficacy evaluation,and according to the analysis of Meta data shows that butylphthalein group are effective:[RR=2.03,95%CI（1.25,3.32）,P<0.05,I²=0];Six studies reported adverse drug events and no serious adverse events occurred.Conclusion:The results of this systematic evaluation indicated that the treatment of vascular dementia was effective and safe,but more high quality randomized double-blind controlled trials were needed.