摘要
目的系统评价中药相关疗法对阿尔兹海默病(AD)患者简易精神状态检查表(MMSE)、日常生活能力量表(ADL)评分的影响。方法检索中国知网(CNKI)、万方数据库、维普智立方、PubMed、Springer、Web of Science、爱思唯尔ScienceDirect数据库,时间从建库至2019年6月30日,检索中药复方治疗AD的随机对照试验(RCT),两名研究员独立筛选符合纳入标准的文献,评价偏倚风险,采用Review Manager 5.3进行统计分析。结果纳入的39篇RCT均在国内开展,治疗种类包括中药-西药-灸法、中药-西药、中药3种;在各治疗时点(1、2、3、6、NR个月),中药治疗有效率均高于西药(P<0.01),中药各治疗时间合并有效率优于西药(P<0.05);各治疗时点(1、2、3、6、NR个月)均可提高MMSE评分(P<0.05),中药各治疗时间合并[MD=1.82,95%CI(0.91,2.72)]可有效提高MMSE评分(P<0.0001);仅治疗时间6个月[MD=-3.82,95%CI(-7.15,-0.49)]可有效降低ADL评分(P=0.02),中药各治疗时间合并[MD=-1.00,95%CI(-4.56,2.56)]对降低ADL评分无明显作用(P=0.58)。结论中药治疗AD的有效率优于常规西药治疗,可改善患者MMSE、ADL评分,并与治疗时间相关。考虑到本研究的局限性,相关结论仍需大样本、设计合理的RCT研究进行补充论证。
Objective To systematically evaluate the effect of traditional Chinese medicine compound on MMSE and ADL scores of patients with Alzheimer’s disease.Methods The databases of CNKI,Wanfang Data knowledge service platform,VIP Wisecube,PubMed,Springer,web of science,Elsevier ScienceDirect were searched from database building to June 30,2019.The randomized controlled trial(RCT)of traditional Chinese medicine compound in the treatment of Alzheimer’s disease(AD)was searched.The two researchers independently screened the literatures that met the inclusion criteria and evaluated them on the risk of bias.Statistical analysis was conducted with Review Manager 5.3.Results The 39 randomized controlled trials were carried out in China,and the types of therapy included traditional Chinese medicine-western medicine-moxibustion,traditional Chinese medicine-western medicine and traditional Chinese medicine.In each treatment time(1,2,3,6,NR months),the effective rate of traditional Chinese medicine was higher than that of western medicine(P<0.01),and the combined treatment time on effective rate of traditional Chinese medicine was better than that of western medicine(P<0.05);the MMSE scores were increased in treatment time of 1,2,3,6 and NR months(P<0.05).The MMSE scores were increased in combined treatment time of traditional Chinese medicine[MD=1.82,95%CI(0.91,2.72)];the ADL scores were decreased only in treatment time of 6 months[MD=-3.82,95%CI(-7.15,-0.49)].The combined treatment time of traditional Chinese medicine[MD=-1.00,95%CI(-4.56,2.56)]had no significant effect on the ADL scores(P=0.58).Conclusion The effective rate of traditional Chinese medicine in treating Alzheimer’s disease is better than that of conventional western medicine,and it can improve the MMSE and ADL scores of patients,which is related to the treatment time.Considering the limitations of this study,the relevant conclusions still need large sample and reasonable design of RCT study for supplementary demonstration.
作者
王雨
罗楠
曾楚华
陈龙菊
冉思邈
袁德培
WANG Yu;LUO Nan;ZENG Chuhua;CHEN Longju;RAN Simiao;YUAN Depei(Medical School,Hubei Minzu University,Enshi 445000,China;Qingdao Hospital of Traditional Chinese Medicine(Qingdao Haici Hospital),Qingdao 266033,China;Basic Medical College,Hubei University of Traditional Chinese Medicine,Wuhan 430065,China)
出处
《湖北民族大学学报（医学版）》
2020年第3期7-13,19,共8页
Journal of Hubei Minzu University(Medical Edition)
基金
国家自然科学基金(81860811)。
关键词
阿尔兹海默病
中药复方
有效率
MMSE评分
ADL评分
Alzheimer’s disease
traditional Chinese medicine compound
effective rate
MMSE scores
ADL scores
