Hao Zilong, Liu Ming, Liu Zhiqin, Lv Donghao
Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan Province, China, 610041.
Cochrane Database Syst Rev. 2009 Apr 15(2):CD007365. doi: 10.1002/14651858.CD007365.pub2.
Huperzine A, a form of herbal medicine, has been considered as an alternative treatment for vascular dementia (VaD) in China.
To assess the efficacy and safety of Huperzine A in patients with vascular dementia.
The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) was searched on 7 July 2008 using the terms: huperzi* OR ayapin OR scoparon*. The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources. The review authors searched the following databases in August 2008 using the terms 'Huperzine A', 'Shishanjianjia', 'Haboyin' and 'Shuangyiping': The Chinese Biomedical Database (CBM) (1977 to August 2008); Chinese Science and Technique Journals Database (VIP) (1989 to August 2008); China National Knowledge Infrastructure (CNKI) (1979 to August 2008); The Chinese Clinical Trials Register (ChiCTR, August 2008); Google (August 2008). In addition, the review authors searched reference lists, relevant clinical trials and contacted researchers in an effort to identify further published and unpublished studies.
Randomized controlled trials comparing Huperzine A with placebo in patients with vascular dementia were considered eligible for inclusion.
Two review authors independently selected trials for inclusion, assessed trial quality, and extracted data.
Only one small trial, involving 14 participants, was included. No significant beneficial effect of Huperzine A on the improvement of cognitive function measured by MMSE for VaD (WMD 2.40; 95% CI -4.78 to 9.58) was observed. No death from all causes at the end of treatment were reported. At present, other outcome measures were not available in any of the trials. Although no statistically significant differences were found between the Huperzine A-treated and control groups, the confidence intervals for the treatment effect estimates were wide and included both clinically significant benefits and clinically significant harms.
AUTHORS' CONCLUSIONS: There is no [convincing] evidence that Huperzine A is of value in vascular dementia based on one small trial. It deserves further research.
石杉碱甲作为一种草药，在中国已被视为血管性痴呆（VaD）的一种替代治疗方法。
评估石杉碱甲治疗血管性痴呆患者的疗效和安全性。
2008年7月7日，使用检索词“huperzi* OR ayapin OR scoparon*”检索了Cochrane痴呆与认知改善小组（CDCIG）的专业注册库。CDCIG专业注册库包含来自所有主要医疗保健数据库（Cochrane图书馆、MEDLINE、EMBASE、PsycINFO、CINAHL、LILACS）以及许多试验数据库和灰色文献来源的记录。2008年8月，综述作者使用检索词“石杉碱甲”、“石杉碱甲胶囊”、“哈伯因”和“双益平”检索了以下数据库：中国生物医学文献数据库（CBM）（1977年至2008年8月）；中文科技期刊数据库（VIP）（1989年至2008年8月）；中国知网（CNKI）（1979年至2008年8月）；中国临床试验注册中心（ChiCTR，2008年8月）；谷歌（2008年8月）。此外，综述作者还检索了参考文献列表、相关临床试验并联系了研究人员，以确定更多已发表和未发表的研究。
比较石杉碱甲与安慰剂治疗血管性痴呆患者的随机对照试验被认为符合纳入标准。
两名综述作者独立选择纳入试验、评估试验质量并提取数据。
仅纳入了一项小型试验，涉及14名参与者。未观察到石杉碱甲对血管性痴呆患者通过简易精神状态检查表（MMSE）测量的认知功能改善有显著有益效果（加权均数差2.40；95%可信区间-4.78至9.58）。治疗结束时未报告任何原因导致的死亡。目前，任何试验中均未提供其他结局指标。虽然石杉碱甲治疗组与对照组之间未发现统计学显著差异，但治疗效果估计值的可信区间较宽，既包括临床上显著的益处，也包括临床上显著的危害。
基于一项小型试验，尚无[令人信服的]证据表明石杉碱甲对血管性痴呆有价值。值得进一步研究。
