Chi Jung-fang, Niu Jian-zhao, Xu Shu-qiang, Li Jian, Wang Ji-feng, Liu Jian-ping
Laboratory of Cell and Biochemistry, Beijing University of Chinese Medicine, Beijing 100029, China.
Zhong Xi Yi Jie He Xue Bao. 2007 May;5(3):247-54. doi: 10.3736/jcim20070304.
The purpose of this research was mainly two-fold: first, to get an understanding of current researches conducted on Alzheimer disease in China; second, to systematically evaluate and compare Alzheimer's treatment delivered by traditional Chinese medicine (TCM) and Western medicine.
Two steps were employed in this research. They were data collection and cleaning, followed by systemic review and qualitative analysis. The data were selected from the following two databases: CNKI (http://www.cnki.net) and Wanfang Data (http://www.wanfangdata.com.cn). Inclusion criteria were: (1) Chinese literature; (2) Published between year 1994 and year 2004; (3) Using TCM as treatment and Western medicine as control; (4) Similar research purposes and methodology; (5) Subjects were diagnosed as Alzheimer disease. Descriptive analysis, homogeneity test, meta analysis, sensitivity analysis and subgroup analysis were performed in the second step.
Supposing all qualified studies were of high quality, we got the following conclusion: the advantage of TCM was losing because of the newly-developed acetylcholinesterase inhibitors came in market. Moreover, the studies conducted after year 2002 were more homogeneous in comparison with those conducted in early years. Those studies using mini-mental status examination (MMSE) as outcome measurement were also more homogeneous than non-MMSE measurement groups. Combined odds ratio in comparative studies was 1.5 fold higher than that in experimental studies. Regarding to different outcome measurement, those studies using TCM assessment profile were 2.58(4.79/1.86) fold higher than those using MMSE as outcome measurement.
After systemic literature search, we found that only 40 out of 2,403 studies met our inclusion criteria. Moreover, those qualified studies were of low quality. Therefore, the external validity of this study would be compromised. The solution to this would be to improve study quality by strengthening study design and carefully select more homogeneous subjects in terms of syndrome differentiation, by so doing, the results of meta analysis will be more convincing and easily recognized by international society.
本研究主要有两个目的：其一，了解中国目前关于阿尔茨海默病的研究情况；其二，系统评估和比较中医与西医对阿尔茨海默病的治疗效果。
本研究采用两个步骤。首先是数据收集与清理，然后是系统评价和定性分析。数据选自以下两个数据库：中国知网（http://www.cnki.net）和万方数据（http://www.wanfangdata.com.cn）。纳入标准为：（1）中文文献；（2）发表于1994年至2004年之间；（3）以中医为治疗方法、西医为对照；（4）研究目的和方法相似；（5）研究对象被诊断为阿尔茨海默病。第二步进行描述性分析、同质性检验、荟萃分析、敏感性分析和亚组分析。
假设所有符合条件的研究质量都很高，我们得出以下结论：由于新开发的乙酰胆碱酯酶抑制剂上市，中医的优势正在丧失。此外，2002年后进行的研究比早期的研究同质性更强。那些使用简易精神状态检查表（MMSE）作为结果测量指标的研究也比非MMSE测量组的同质性更强。比较研究中的合并优势比是实验研究中的1.5倍。关于不同的结果测量指标，那些使用中医评估量表的研究比使用MMSE作为结果测量指标的研究高2.58（4.79/1.86）倍。
经过系统的文献检索，我们发现2403项研究中只有40项符合我们的纳入标准。此外，这些符合条件的研究质量较低。因此，本研究的外部有效性会受到影响。解决办法是通过加强研究设计来提高研究质量，并在辨证方面精心选择更具同质性的研究对象，这样，荟萃分析的结果将更具说服力，并更容易被国际社会认可。
