A Meta-Analysis of Au/Polypropionic Acid Nanoparticles Loaded with Olacetam for the Treatment of Vascular Cognitive Impairment
To systematically evaluate the efficacy and safety of oxetam in the treatment of vascular cognitive dysfunction and the feasibility of an Au/polypropionic acid Nanometer drug delivery system to provide evidence for clinical application. PubMed, Shanghai embase, Cochrane Library, CNKI, VIP information, and Wanfang database were searched from the establishment of the database to April 2018. Patients were divided into two groups according to whether they received olacetam: the experimental group and the control group. In addition, the control group was divided into the placebo control group and the positive control group according to whether the control group received a placebo or other medication treatment controls. In the control group, a meta-analysis, a publication bias assessment, and sensitivity analysis were performed with Revman 5.3 and Stata 14.0. The results of the meta-analysis showed that compared with placebo and other medications, oxiracetam significantly improved the mental status of patients, Concise Mental State Checklist score [mean difference (MD)= 5.29, P < 0.01] and Montreal Cognitive Assessment score (MD = 4.32, P < 0.01). The Barthel Index demonstrated that oxiracetam significantly improved the quality of the daily life of patients (MD = 18, P < 0.01), but there was no difference between olacetam and placebo or other medications in the rating of activities of daily living (ADLs). The total effective rate of olacetam was significantly higher than that of other treatments (P < 0.01). Compared with placebo and other medications, the safety of oxiracetam was not significantly different (P > 0.05). Based on the current clinical evidence, olacetam is more effective and safer than alternatives in the treatment of vascular cognitive dysfunction.