School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
Evid Based Complement Alternat Med. 2012;2012:426215. doi: 10.1155/2012/426215. Epub 2011 Oct 20.
We present a systematic review of existing research that aims to assess the efficacy and safety of herbal medications (HM), as either monotherapy or adjunct to orthodox medications (OM), mainly comprised of cholinesterase inhibitors, for vascular dementia (VaD). We included 47 studies conducted in mainland China, each testing different HM. Of 43 HM monotherapy studies, 37 reported HM to be significantly better than OM or placebo; six reported similar efficacy between HM and OM. All four HM adjuvant studies reported significant efficacy. No major adverse events for HM were reported. Heterogeneity in diagnostic criteria, interventions and outcome measures hindered comprehensive data analysis. Studies suggested that HM can be a safe and effective treatment for VaD, either alone or in conjunction with OM. However, methodological flaws in the design of the studies limited the extent to which the results could be interpreted. Thirty most commonly used herbal constituents, including Rhizoma Chuanxiong (Chuanxiong in Chinese), Radix Polygoni Multiflori (Heshouwu in Chinese) and Radix Astragali (Huangqi in Chinese). were ranked. Further multi-center trials with large sample sizes, high methodological quality and standardized HM ingredients are necessary for clinical recommendations to be made.
我们对现有研究进行了系统回顾，旨在评估草药药物（HM）作为单一疗法或与传统药物（OM）联合治疗血管性痴呆（VaD）的疗效和安全性，OM 主要包括胆碱酯酶抑制剂。我们纳入了在中国内地进行的 47 项研究，每项研究都测试了不同的 HM。在 43 项 HM 单药治疗研究中，有 37 项研究报告 HM 明显优于 OM 或安慰剂；6 项研究报告 HM 与 OM 的疗效相似。四项 HM 辅助治疗研究均报告了显著疗效。未报告 HM 有任何重大不良事件。诊断标准、干预措施和结局测量的异质性阻碍了综合数据分析。研究表明，HM 可作为 VaD 的安全有效治疗方法，无论是单独使用还是与 OM 联合使用。然而，研究设计中的方法学缺陷限制了对结果的解释程度。排名前 30 的最常用草药成分，包括川芎（川芎）、制何首乌（何首乌）和黄芪（黄芪）。需要进行更多的多中心试验，样本量大、方法学质量高且 HM 成分标准化，以便提出临床建议。
