姑息治疗对老年痴呆患者干预效果的Meta分析

Meta-Analysis of Intervention Effect of Palliative Treatment on Senile Dementia Patients

摘要: 目的：评价姑息治疗对老年痴呆患者的干预效果。方法：从数据库建立之日起至2022年11月22日，在PubMed、Embase、Cochrane图书馆、SinoMed、中国知网、万方和维普等数据库中进行计算机辅助检索，搜索关于晚期痴呆患者姑息治疗的随机对照试验或非随机临床试验。两位研究人员独立审阅文献，并使用Revman 5.4软件提取数据进行Meta分析。结果：共纳入8篇文献，总计共1460例患者，姑息治疗可以提升临终舒适度，[SMD = 0.30, 95% CI (0.10, 0.50)，P < 0.01, I2 = 13%]，增强症状管理能力[SMD = 0.34, 95% CI (0.09, 0.59), P = 0.008]，但对于提高生活质量[P = 0.44, I2 = 27%]和护理质量[P = 0.07, I2 = 44%]证据不充分。结论：当前的证据表明，姑息治疗可以在一定程度上增加老年痴呆症患者的临终舒适度和提高其症状管理能力，对生活质量和护理质量的提高证据不充分。

Abstract: Objective: To evaluate the effect of palliative treatment on the elderly with dementia. Method: Randomized or non-randomized controlled studies on palliative care in patients with advanced Alzheimer’s disease by computer retrieval of Pub Med, Embase, Cochrane Library, Sino Med, CNKI, Wanfang and Weipu databases. The search time is from the establishment of the database to November 22nd, 2022. Two researchers independently screened the literatures and extracted the data, and used Revman 5.4 software for Meta-analysis. Results: A total of 8 literatures were included, with a total of 1460 patients. Palliative treatment can increase the death comfortable. [SMD = 0.30, 95% CI (0.10, 0.50), P < 0.01, I2 = 13%]. Enhance the ability of symptom management [SMD = 0.34, 95% CI (0.09, 0.59), P = 0.008]. However, there is insufficient evidence for improving the quality of life [P = 0.44, I2 = 27%] and nursing care [P = 0.07, I2 = 44%]. Conclusions: Current evidence suggests that Palliative treatment can increase the death comfort of Alzheimer’s patients and improve their symptom management ability to a certain extent. However, there is insufficient evidence for the improvement of quality of life and care.