12种口服中成药联合多奈哌齐治疗痴呆的贝叶斯网状Meta分析

Bayesian Network Meta-analysis of 12 Oral Chinese Patent Medicines Combined with Donepezil in the Treatment of Dementia

目的:运用贝叶斯网状Meta分析的方法系统评价12种口服中成药联合多奈哌齐治疗痴呆的有效性及安全性。方法:在国家知识基础设施数据库(CNKI)、中国生物医学文献数据库(CBM)、中国学术期刊数据库(CSPD)及中文科技期刊数据库(CCD)、EMbase、Pubmed、Cochrane Library、Web of Science等主流数据库中进行了系统搜索,并查询ClinicalTrials.gov临床注册系统,检索起止时间为建库至2020年9月。所有纳入的随机对照试验均采用Cochrane系统评价手册进行质量评估。采用Stata 16.0、ADDIS1.16.8软件进行网状Meta分析。结果:最终纳入26个RCT,涉及12种口服中成药,网状Meta分析结果显示,在临床有效率方面,多奈哌齐联合复方海蛇胶囊排序最高;在改善认知功能方面,多奈哌齐联合灯盏生脉胶囊排序最高。结论:在多奈哌齐治疗基础上,加用中成药可提高临床治疗的有效性。建议今后进行中成药之间直接比较的高质量RCT,以提供更强有力的证据。

Objective:To systematically evaluate the efficacy and safety of 12 oral Chinese patent medicines combined with donepezil in the treatment of dementia by using Bayesian network Meta-analysis.Methods:China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Chinese Academic Journal Database(CSPD),Chinese Science and Technology Journal Database(CCD),EMbase,Pubmed,Cochrane Library,and Web of Science were retrieved,and ClinicalTrials.gov was searched from the establishment of the database to September 2020.The Cochrane bias risk assessment tool was used to evaluate the quality of all the included randomized controlled trials(RCTs).Data analysis was conducted using Stata 16.0 and ADDIS1.16.8.Results:Twenty-six RCTs were finally included,involving 12 oral Chinese patent medicines.The results of the network Meta-analysis showed that donepezil combined with compound Haishe Capsules ranked highest in terms of clinical effectiveness.In terms of improving cognitive function,donepezil combined with Dengzhan Shengmai Capsules ranked highest.Conclusion:On the basis of donepezil treatment,the addition of Chinese patent medicines can improve the effectiveness of clinical treatment.It is recommended that high-quality RCTs of direct comparison between Chinese patent medicines be conducted in the future to provide stronger evidence.