May Brian H, Lit M, Xue Charlie C L, Yang Angela W H, Zhang Anthony L, Owens Michael D, Head Richard, Cobiac Lynne, Li Chun Guang, Hugel Helmut, Story David F
WHO Collaborating Centre for Traditional Medicine, School of Health Sciences, RMIT University, Australia.
Phytother Res. 2009 Apr;23(4):447-59. doi: 10.1002/ptr.2656.
This systematic review aimed to assess the effectiveness and safety of herbal medicines (HM) for treating dementia. Databases in English and Chinese were searched from their inceptions to February 2007. References in reviews and randomized controlled trials (RCTs) were screened by hand. Trials comparing orally administered HM with placebo, no intervention or other therapy were considered. Trials on Ginkgo biloba and its extracts were excluded to avoid duplication of existing reviews. Pairs of authors independently applied eligibility criteria, extracted data and assessed methodological quality using the Jadad Scale. Thirteen RCTs met the inclusion criteria of three or above on this scale. Six trials compared herbal medicine with placebo, one with no treatment, and the remainder with pharmaceutical intervention. Meta-analyses were performed on common cognitive performance outcome measures. All studies reported HM had significant effects in improving symptoms. In studies that employed active controls, HM was at least as effective as the pharmaceutical intervention. Meta-analyses found HM more effective than no treatment or placebo and at least equivalent to control interventions, although the overall effect was small. No severe adverse events were reported. These trials provide overall positive evidence for the effectiveness and safety of certain HMs for dementia management.
本系统评价旨在评估草药治疗痴呆症的有效性和安全性。检索了英文和中文数据库自建库至2007年2月的文献。通过手工筛选综述和随机对照试验（RCT）中的参考文献。纳入比较口服草药与安慰剂、无干预措施或其他疗法的试验。排除银杏叶及其提取物的试验，以避免与现有综述重复。两位作者独立应用纳入标准、提取数据并使用雅达量表评估方法学质量。13项RCT在此量表上达到了三项或以上的纳入标准。六项试验将草药与安慰剂进行比较，一项与无治疗进行比较，其余与药物干预进行比较。对常见的认知表现结局指标进行了荟萃分析。所有研究均报告草药在改善症状方面有显著效果。在采用积极对照的研究中，草药至少与药物干预一样有效。荟萃分析发现，草药比无治疗或安慰剂更有效，且至少等同于对照干预措施，尽管总体效果较小。未报告严重不良事件。这些试验为某些草药治疗痴呆症的有效性和安全性提供了总体积极的证据。
