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对抗阿尔茨海默病性痴呆的希望之叶:临床试验系统评价

: A Leaf of Hope in the Fight against Alzheimer's Dementia: Clinical Trial Systematic Review.

作者信息

Pagotto Guilherme Lopes de Oliveira, Santos Livia Maria Oliveira Dos, Osman Najwa, Lamas Caroline Barbalho, Laurindo Lucas Fornari, Pomini Karina Torres, Guissoni Leila M, Lima Enzo Pereira de, Goulart Ricardo de Alvares, Catharin Virginia M C Strozze, Direito Rosa, Tanaka Masaru, Barbalho Sandra Maria

机构信息

Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Higino Muzzi Filho, 1001, Marília 17525-902, SP, Brazil.

Department of Gerontology, Universidade Federal de São Carlos, UFSCar, São Carlos 13565-905, SP, Brazil.

出版信息

Antioxidants (Basel). 2024 May 27;13(6):651. doi: 10.3390/antiox13060651.

Abstract

Alzheimer's disease (AD) is a stealthy and progressive neurological disorder that is a leading cause of dementia in the global elderly population, imposing a significant burden on both the elderly and society. Currently, the condition is treated with medications that alleviate symptoms. Nonetheless, these drugs may not consistently produce the desired results and can cause serious side effects. Hence, there is a vigorous pursuit of alternative options to enhance the quality of life for patients. (GB), an herb with historical use in traditional medicine, contains bioactive compounds such as terpenoids ( A, B, and C), polyphenols, organic acids, and flavonoids (quercetin, kaempferol, and isorhamnetin). These compounds are associated with anti-inflammatory, antioxidant, and neuroprotective properties, making them valuable for cognitive health. A systematic search across three databases using specific keywords-GB in AD and dementia-yielded 1702 documents, leading to the selection of 15 clinical trials for synthesis. In eleven studies, GB extract/EGb 761 was shown to improve cognitive function, neuropsychiatric symptoms, and functional abilities in both dementia types. In four studies, however, there were no significant differences between the GB-treated and placebo groups. Significant improvements were observed in scores obtained from the Mini-Mental State Examination (MMSE), Short Cognitive Performance Test (SKT), and Neuropsychiatric Inventory (NPI). While the majority of synthesized clinical trials show that biloba has promising potential for the treatment of these conditions, more research is needed to determine optimal dosages, effective delivery methods, and appropriate pharmaceutical formulations. Furthermore, a thorough assessment of adverse effects, exploration of long-term use implications, and investigation into potential drug interactions are critical aspects that must be carefully evaluated in future studies.

摘要

阿尔茨海默病(AD)是一种隐匿性进行性神经疾病,是全球老年人群痴呆症的主要病因,给老年人和社会都带来了沉重负担。目前,该病通过缓解症状的药物进行治疗。然而,这些药物可能无法始终产生预期效果,并且会引起严重的副作用。因此,人们积极寻求其他选择以提高患者的生活质量。银杏叶(GB)是一种在传统医学中有悠久使用历史的草药,含有生物活性化合物,如萜类化合物(A、B和C)、多酚、有机酸和黄酮类化合物(槲皮素、山奈酚和异鼠李素)。这些化合物具有抗炎、抗氧化和神经保护特性,对认知健康具有重要价值。使用特定关键词“AD和痴呆症中的GB”在三个数据库中进行系统检索,得到1702篇文献,从中筛选出15项临床试验进行综合分析。在11项研究中,GB提取物/银杏叶提取物761被证明可改善两种痴呆类型的认知功能、神经精神症状和功能能力。然而,在4项研究中,GB治疗组和安慰剂组之间没有显著差异。在简易精神状态检查表(MMSE)、简易认知能力测试(SKT)和神经精神科问卷(NPI)的得分上观察到了显著改善。虽然大多数综合临床试验表明银杏叶在治疗这些疾病方面具有潜在的前景,但仍需要更多研究来确定最佳剂量、有效的给药方法和合适的药物制剂。此外,对不良反应进行全面评估、探讨长期使用的影响以及调查潜在的药物相互作用是未来研究中必须仔细评估的关键方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2a/11201198/9f330b7b0ecd/antioxidants-13-00651-g001.jpg

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