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基于 697 例患者的荟萃分析:芪附饮治疗痴呆的临床疗效如何?

Is Qi Fu Yin effective in clinical treatment of dementia?: A meta-analysis of 697 patients.

机构信息

College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan.

Institute of Pharmacology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian.

出版信息

Medicine (Baltimore). 2021 Feb 5;100(5):e24526. doi: 10.1097/MD.0000000000024526.

Abstract

BACKGROUND

Dementia, a kind of acquired and progressive intelligence-damaging syndrome, is induced by cerebral dysfunction. Ancient records show that Qi Fu Yin (QFY) has the advantages in age-related dementia treatment. This study aims to evaluate therapeutic efficacy of QFY on dementia through meta-analysis.

METHODS

We comprehensively reviewed articles from various databases, including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Chinese Biomedical Literature (CBM), PubMed, and Web of Science published before June 2020, for all randomized controlled trials (RCTs) on dementia treatment with QFY. Then, we selected eligible literatures, extracted related data, and assessed risk of bias. Forest plots of total clinical effective rate, MMSE score, HDS score and ADL score illustrated the difference between the experimental group (treatment with QFY alone or combined with routine western medicine) and the control group (treatment with routine western medicine only). Random effects model and fixed effects model were adopted. Finally, publication bias was further analyzed using funnel plot, sensitivity analysis, Begg and Egger test.

RESULTS

Finally, 9 RCTs, involving 697 patients, were included in this study. The results revealed that the total clinical effective rate of the experimental group was obviously higher than that of the control group (OR = 0.33, 95% CI [0.22, 0.50], P < .001). In comparison with the control group, the experimental group showed higher MMSE score (WMD = 2.60, 95% CI [2.16, 3.03], P < .001) and HDS score (WMD = 1.51, 95%CI [1.10, 1.92], P < .001). Due to few included studies, there were no statistically significance between experimental and control groups (WMD = -9.90, 95%CI [-26.09, 6.30], P = .231) regarding ADL score. In addition, there is no publication bias towards clinical effective rate and MMDE score.

CONCLUSIONS

QFY only or combined with western medicine therapy can significantly improve cognitive ability compared with only western medicine therapy in dementia. However, multiple samples, RCTs of high quality are still needed to verify our conclusions.

摘要

背景

痴呆是一种获得性、进行性的智力损害综合征,由大脑功能障碍引起。古代文献记载,芪福饮(QFY)在治疗与年龄相关的痴呆方面具有优势。本研究旨在通过荟萃分析评估 QFY 治疗痴呆的疗效。

方法

我们全面检索了中国知网(CNKI)、万方、维普、中国生物医学文献数据库(CBM)、PubMed 和 Web of Science 等数据库中 2020 年 6 月前发表的关于 QFY 治疗痴呆的所有随机对照试验(RCT),纳入符合标准的文献,提取相关数据,并评估偏倚风险。总临床有效率、MMSE 评分、HDS 评分和 ADL 评分的森林图显示了实验组(单独使用 QFY 或联合常规西药治疗)和对照组(仅使用常规西药治疗)之间的差异。采用随机效应模型和固定效应模型。最后,使用漏斗图、敏感性分析、Begg 和 Egger 检验进一步分析发表偏倚。

结果

最终纳入 9 项 RCT,共 697 例患者。结果表明,实验组的总临床有效率明显高于对照组(OR=0.33,95%CI[0.22,0.50],P<0.001)。与对照组相比,实验组的 MMSE 评分(WMD=2.60,95%CI[2.16,3.03],P<0.001)和 HDS 评分(WMD=1.51,95%CI[1.10,1.92],P<0.001)更高。由于纳入的研究较少,实验组与对照组的 ADL 评分无统计学差异(WMD=-9.90,95%CI[-26.09,6.30],P=0.231)。此外,临床有效率和 MMDE 评分不存在发表偏倚。

结论

QFY 单独或联合西药治疗可显著改善痴呆患者的认知能力,优于单纯西药治疗。然而,仍需要更多的样本、高质量的 RCT 来验证我们的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce44/7870270/04d290b7f510/medi-100-e24526-g001.jpg

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