补肾益髓法治疗阿尔茨海默病的Meta分析

Bushen Yisui Method in the Treatment of Alzheimer's Disease:A Meta-Analysis

目的:系统评价中医应用补肾益髓法治疗阿尔茨海默病(alzheimer s disease,AD)的临床疗效。方法:计算机检索CNKI、VIP、WanFang Data、CBM、The Cochrane Library、EMbase和PubMed数据库,搜集关于中医补肾益髓法治疗阿尔茨海默病的随机对照临床试验,检索时限均从建库以来至2021年6月。根据纳入和排除标准筛选文献后采用Revman 5.4软件进行系统评价。结果:最终纳入研究20个,共1733例患者,其中补肾益髓法的中药治疗组879例,对照组854例。与对照组(盐酸多奈哌齐片或甲磺酸双氢麦角碱或脑复康片或复方吡拉西坦脑蛋白水解物片)相比,补肾益髓法的中药治疗组简易智力状态检查量表评分[MD=2.15,95%CI(1.30,3.00),P<0.001]和有效率[RR=1.23,95%CI(1.16,1.31),P<0.001]均明显高于对照组;补肾益髓法的中药治疗组AD评估量表-认知功能部分评分[MD=-4.14,95%CI(-5.56,-2.71),P<0.001]、日常生活能力量表评分[MD=-2.48,95%CI(-3.71,-1.26),P<0.001]和中医证候积分评分[MD=-5.23,95%CI(-7.27,-3.19),P<0.001]与对照相比均明显下降;不良反应的发生率两组差异无统计学意义[RR=0.56,95%CI(0.30,1.05),P=0.07>0.01]。结论:应用补肾益髓法的中药治疗AD可进一步改善患者的认知功能,提高患者生活质量和临床疗效,不良反应并未增加。但由于纳入研究的质量较低,上述结论仍需更多高质量随机对照试验加以验证。

Objective To systematically evaluate the clinical efficacy of Chinese medicine in the treatment of Alzheimer's disease(AD)by Bushen Yisui Method.Methods The databases of CNKI,VIP,WanFang Data,CBM,The Cochrane Library,EMbase and PubMed,were searched by computer to collect randomized controlled clinical trials of TCM Bushen Yisui Method for the treatment of Alzheimer's disease.The retrieval time limits are all from the beginning of the database to June 2021.After literature selection,Revman 5.4 software was used for system evaluation.Results A total of 1733 patients,879 patients in the treatment group and 854 patients in the control group,were included in 20 studies.Compared with the control group(Donepezil hydrochloride tablets or dihydroergocline mesylate tablets or Naofukang tablets or compound Piracetam brain proteolytic tablets),the mini-mental state examination score[MD=2.15,95%CI(1.30,3.00),P<0.001]and the effective rate[RR=1.23,95%CI(1.16,1.31),P<0.001]of the Chinese medicine treatment group were significantly higher than those of the control group.The AD assessment scale-cognitive subscale score[MD=-4.14,95%CI(-5.56,-2.71),P<0.001],activities of daily living scale score[MD=-2.48,95%CI(-3.71,-1.26),P<0.001]and TCM syndrome integral score[MD=-5.23,95%CI(-7.27,-3.19),P<0.001]of the Chinese medicine treatment group compared with the control group was significantly decreased.There was no statistically significant difference in the incidence of adverse reactions between the two groups[RR=0.56,95%CI(0.30,1.05),P=0.07>0.01].Conclusion The traditional Chinese medicine therapy of AD can further improve the patients cognitive function,improve the patients quality of life and clinical efficacy,adverse reactions did not increase.However,on account of the low quality of the included studies,more high-quality randomized controlled trials are needed to verify the above conclusions.