补肾益智方药治疗阿尔茨海默病疗效的系统评价与Meta分析

Systematic Evaluation and Meta-Analysis of the Curative Effect of Bushen Yizhi Formula on Alzheimer′s Disease

目的:评价补肾益智方药干预阿尔茨海默病的临床疗效。方法:运用计算机检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、PubMed数据库、中国生物医学文献(China Biology Medicine,CBM)数据库、EMbase数据库、The Cochrane Library数据库、Medline数据库,检索时间为建库至2020年1月。纳入相关研究,运用Revman 5.3软件进行数据分析及评价。结果:共纳入31篇文献,涉及患者2730例。1)观察组为补肾益智方药、对照组为盐酸多奈哌齐片。总有效率:RR=1.21,95%CI为1.13~1.29,P<0.01;MMSE评分:MD=1.91,95%CI为-0.17~3.99,P=0.07;ADL评分:MD=-3.35,95%CI为-5.70~-1.00,P<0.01;ADAS-cog评分:MD=-5.51,95%CI为-7.68~-3.35,P<0.01。观察组与对照组比较,其总有效率较高,ADL评分与ADAS-cog评分较低,MMSE评分未见明显变化。2)观察组为补肾益智方药、对照组为唑吡坦片的分析结果为:总有效率:RR=1.24,95%CI为1.17~1.31,P<0.01;MMSE评分:MD=4.82,95%CI为2.52~7.11,P<0.01。观察组与对照组比较,其总有效率较高,MMSE评分较高。由于所纳入研究及报告安全性评价的限制,其安全性仍需进一步临床实验验证。结论:补肾益智方药可在一定程度上改善阿尔茨海默病患者的治疗有效率以及MMSE评分、ADL评分与ADAS-cog评分,改善患者的认知功能及生活能力水平,为临床提供一定依据。

Objective:To evaluate the clinical effects of Bushen Yizhi Formula on Alzheimer′s disease.Methods:CNKI,PubMed,CSPD,CCD,CBM,EMbase,Medline and the Cochrane library were searched by computer from the establishment of the database to January 2020.Relevant studies were included,and Revman 5.3 software was used for data analysis and evaluation.Results:A total of 31 papers were included,involving 2730 patients.1)Among them,the experimental group was a prescription for Bushen Yizhi Formula and the control group is donepezil hydrochloride tablets.The total effective rate was RR=1.21[1.13,1.29],P<0.01;MMSE score:MD=1.91[-0.17,3.99],P=0.07;ADL score:MD=-3.35[-5.70,-1.00],P<0.01;ADAS cog score:MD=-5.51[-7.68,-3.35],P<0.01).Compared with the control group,the experimental group had a higher total effective rate.ADL score and ADAS-cog score were lower,and MMSE score had no significant change.2)The experimental group was Bushen Yizhi Formula,while the control group was zolpidem tablets.The total effective rate:RR=1.24[1.17,1.31],P<0.01;MMSE score:MD=4.82[2.52,7.11],P<0.01.The total effective rate of the experimental group was higher than that of the control group,and MMSE score was higher.Due to the limitation of the safety evaluation of the included researches and reports,its safety still needs to be further verified by clinical trials.Conclusion:Bushen Yizhi Formula can improve the total effective rate,MMSE score,ADL score and ADAS-cog score of Alzheimer′s disease patients to a certain extent,improve the cognitive function and living ability of patients,and provide some basis for clinical practice.