中药治疗多发梗死性痴呆临床疗效的Meta分析

Clinical Efficacy of Traditional Chinese Medicine on Multiple Infarcted Dementia:a Meta-analysis

目的系统评价中药治疗多发梗死性痴呆(MID)的临床疗效,为临床治疗提供循证参考。方法计算机检索中国知网(CNKI)、万方数据库(WanFang)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMbase和The Cochrane Library,收集各数据库建库至2020年11月30日公开发表的中药治疗多发梗死性痴呆的随机对照试验(RCT)。筛选文献、提取资料,采用Cochrane Risk of Bias对纳入研究进行质量评价,并应用RevMan 5.3软件进行Meta分析。结果共纳入14项RCT,涉及1337例受试者。Meta分析结果显示,试验组在改善病人简易精神状态检查量表评分[WMD=2.30,95%CI(0.80,3.81),P=0.003]、长谷川痴呆量表[WMD=3.42,95%CI(2.16,4.68),P<0.00001]、Berg平衡量表[MD=-1.17,95%CI(-1.44,-0.90),P<0.00001]、总胆固醇[WMD=-2.50,95%CI(-4.12,-0.87),P=0.003]、三酰甘油[WMD=-0.97,95%CI(-1.56,-0.38),P=0.001]、超氧化物歧化酶[WMD=0.89,95%CI(0.50,1.29),P<0.0001]、过氧化脂质[WMD=-0.68,95%CI(-1.07,-0.29),P=0.0006]方面均优于对照组,差异均有统计学意义。但两组病人在经颅多普勒超声检查方面差异均无统计学意义(P>0.05)。结论现有研究表明,中药在改善多发梗死性痴呆病人的认知功能、保持肢体平衡能力、改善血脂水平以及抗氧化方面均具有潜在优势。

Objective To evaluate the clinical efficacy of traditional Chinese medicine in the treatment of multiple infarction dementia(MID).Methods CNKI,Wanfang,VIP,CBM,PubMed,EMbase,and the Cochrane Library were searched,and the randomized controlled trial(RCTs)of Chinese traditional medicine in the treatment of MID were collected from inception to November 30,2020.Cochrane Risk of Bias was used to evaluate the quality of the included studies.Meta-analysis was performed using RevMan 5.3 software.Results Fourteen RCTs were included,involving 1337 patients.Meta analysis results showed that the improvement of Mental State Examination Rating Scale score[WMD=2.30,95%CI(0.80,3.81),P=0.003],Hasegawa Dementia Scale score[WMD=3.42,95%CI(2.16,4.68),P<0.00001],Berg Balance Scale score[MD=1.17,95%CI(1.44,0.90),P<0.00001],total cholesterol[WMD=-2.50,95%CI(-4.12,-0.87),P=0.003],triacylglycerol[WMD=-0.97,95%CI(-1.56,-0.38),P=0.001],superoxide dismutase[WMD=0.89,95%CI(0.50,1.29),P<0.0001],lipid peroxidase[WMD=-0.68,95%CI(-1.07,-0.29),P=0.0006]in the experimental group were better than those in control group.However,there was no significant difference in dath of transcranial Doppler ultrasonography between two groups(P>0.05).Conclusion The current research showed that traditional Chinese medicine could improve cognitive function,limb balance ability,blood lipid level,and antioxidant capacity in MID patients.