目的 系統(tǒng)評(píng)價(jià)美金剛對(duì)比多奈哌齊治療帕金森病癡呆的療效與安全性。方法 檢索中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、萬(wàn)方數(shù)據(jù)庫(kù)（Wanfang Data）、維普中文期刊全文數(shù)據(jù)庫(kù)（VIP）和中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（SinoMed）、Cochrane Library、PubMed、Web of Science等數(shù)據(jù)庫(kù)自建庫(kù)起至2022年7月1日收錄的有關(guān)美金剛、多奈哌齊分別聯(lián)合多巴絲肼治療帕金森病癡呆的臨床隨機(jī)對(duì)照試驗(yàn)（RCT）。評(píng)估偏倚風(fēng)險(xiǎn)，并收集患者治療后的簡(jiǎn)易精神狀態(tài)量表（MMSE）評(píng)分、蒙特利爾認(rèn)知評(píng)估量表（MoCA）評(píng)分變化情況，臨床總有效率及不良反應(yīng)發(fā)生率，采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果 共納入14項(xiàng)RCTs，總計(jì)1219名患者，其中美金剛聯(lián)合多巴絲肼組610例、多奈哌齊聯(lián)合多巴絲肼組609例。Meta分析結(jié)果顯示，美金剛聯(lián)合多巴絲肼在改善MMSE評(píng)分、改善MoCA評(píng)分、提高臨床總有效率方面效果均優(yōu)于多奈哌齊聯(lián)合多巴絲肼，其差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；美金剛對(duì)比多奈哌齊治療帕金森病癡呆的不良反應(yīng)發(fā)生率更低。結(jié)論 美金剛對(duì)帕金森病癡呆患者的認(rèn)知功能改善效果優(yōu)于多奈哌齊，臨床總有效率更高，且治療后不良反應(yīng)發(fā)生率低。

Objective To systematically evaluate and compare the efficacy and safety of memantine and donepezil in the treatment of Parkinson's disease dementia.Methods CNKI, Wanfang, VIP, SinoMed, Cochrane Library, PubMed, Web of Science were selected to search the randomized controlled trials (RCT) of memantine and donepezil combined with madopar respectively in the treatment of Parkinson's disease dementia, from the date of establishment to July 1, 2022. The risk of bias was evaluated, and the changes in MMSE score, MoCA score, total clinical efficiency rate, and adverse reaction rate after treatment were collected. RevMan 5.3 software was used for Meta-analysis.Results A total of 1 219 patients were enrolled in 14 RCTs, including 610 patients in the combination of memantine and madopar group and 609 patients in the combination of donepezil and madopar group. Meta-analysis results showed that memantine combined with madopar was superior to donepezil combined with madopar in improving MMSE score, MoCA score, and clinical total effective rate, with a statistically significant difference (P<0.05). The adverse reaction rate of memantine combined with donepezil in the treatment of Parkinson's disease dementia was lower.Conclusion Memantine was superior to donepezil in improving the cognitive function of patients with Parkinson's disease dementia, with a higher clinical total effective rate and lower incidence of adverse reactions after treatment.

R969.3;R971

國(guó)家自然科學(xué)基金青年基金資助項(xiàng)目(81303028);山東省中醫(yī)藥科技發(fā)展計(jì)劃資助項(xiàng)目(2019-0107,2019-0094);山東省科技發(fā)展計(jì)劃資助項(xiàng)目(2014GSF119038);濟(jì)南市科技發(fā)展計(jì)劃(202019027,202134007);山東中醫(yī)藥大學(xué)附屬醫(yī)院首批青年科研創(chuàng)新團(tuán)隊(duì)項(xiàng)目