實證醫學專題報告 銀杏是否能預防失智症 ?
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實證醫學專題報告 銀杏是否能預防失智症 ?. 報告者: clerk 曾偉綸 指導者:王啟忠主任 門諾醫院 家醫科 2013 Jan 22th. 情境. 門諾實證競賽題目 王先生年過 60 ,開始擔心身體狀況,他想知道自己未來發生心血管疾病的機率有多少?他開始每天吃深海魚油和綜合維他命,每天早上去公園學太極拳。另外,他還每天 吃銀杏預防阿茲海默症 ,吃維骨力預防關節退化。. 背景資訊. 為何認為銀杏可能可以治療失智症? multiple antioxidants Pietri S, 1997 - PowerPoint PPT PresentationTRANSCRIPT
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?clerk 2013 Jan 22th
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60
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multiple antioxidants Pietri S, 1997anti-amyloid aggregation Luo Y, 2002meta-analysis : Oken BS, 1998Cochrane review : Birks J, 2002
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Patient : elderly people w/ normal cognitive fnIntervention : Ginkgo bilobaComparison : placeboOutcome : dementia incidence
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: dementia, ginkgo, prevention : PubMed : Systematic review of RCT > RCT >... The Oxford 2011 Levels of Evidence: Treatment Benefits
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(mild cog impairment) PICO
Vellas B et al 2012, Lancet20022854France76.35Beth ES et al 2009, JAMA20003069USA79.16.1DeKosky ST et al 2008, JAMA20003069USA79.16.1
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RCT (randomised) (baseline characteristics) ITT (Intention-to-treat analysis) (blind) (dropped out rate)
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ITTVellas B, 2012, LancetOOOOO64%Beth ES, 2009, JAMAOOOOO62%DeKosky ST, 2008, JAMAOOOOO94%
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Ginkgo Biloba for Prevention of Dementia : A Randomized Controlled TrialDeKosky ST,Williamson JD,Fitzpatrick AL,Kronmal RA, Ives DG,Saxton JA,Lopez OL, Burke G,Carlson MC, Fried LP,Kuller LH,Robbins JA,Tracy RP,Woolard NF, Dunn L,Snitz BE,Nahin RL,Furberg CD; Ginkgo Evaluation of Memory (GEM) Study Investigators.JAMA, Vol. 300, No. 19, November 2008
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1b ( RCT)
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>756230696.1120mg bid