Efficacy and Safety of Chinese Herbal Medicines Combined with Chemical Drugs for Alzheimer's Disease:A Systematic Review and Meta-Analysis  

作　　者：Li Xu Wen-Jun Chen Cai-Jun Tian Yan Zhang Yan Ma Tian-Hao Li Hong-Jie Liu Zhe Zhang 

机构地区：[1]Department of the First College English,College of Foreign Language,Shandong University of Traditional Chinese Medicine,Jinan,China [2]Department of Oncology,Linyi People's Hospital,Linyi,China [3]Department of Internal Medicine of Traditional Chinese Medicine,The First Clinical College,Shandong University of Traditional Chinese Medicine,Jinan,China [4]Department of Chinese Materia Medica,College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan,China [5]Department of Medicinal Chemistry,College of Pharmacy,Shandong University of Traditional Chinese Medicine,Jinan,China [6]Community Healthcare Center,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,China [7]Department of Fundamentals of Traditional Chinese Medicine,School of Traditional Chinese Medicine,Jinan University,Guangzhou,China [8]Shandong Co-Innovation Center of Classic TCM Formula,College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan,China

出　　处：《World Journal of Traditional Chinese Medicine》2024年第1期1-13,共13页世界中医药杂志（英文）

基　　金：supported by the 2019-2020 TCM Technology Development Project of Shandong Province(No.2019-0044);Guangdong Basic and Applied Basic Research Foundation(No.2019A1515010644);Project of Traditional Chinese Medicine Bureau of Guangdong Province(No.20201073);General Program of National Natural Science Foundation of China(No.82074306)。

摘　　要：Objective:To evaluate the efficacy and safety of Chinese herbal medicines(CHMs)combined with chemical drugs for the treatment of Alzheimer's disease(AD).Materials and Methods:Databases were searched to retrieve randomized controlled trials(RCTs)of CHMs combined with tacrine,galantamine,rivastigmine,donepezil,or memantine,following strict inclusion and exclusion criteria.Only research papers published in English,Chinese,and Japanese were considered.The primary outcome was the mini-mental state examination(MMSE)score and the secondary outcomes were AD assessment scale cognitive subscale(ADAS-Cog)score and safety evaluation.Meta-analysis was carried out using Rev Man 5.3 and subgroup analysis was conducted to identify the sources of heterogeneity.Results:A total of 15 RCTs with 1386 participants were included in this study.Only donepezil was used in the retrieved literature.Meta-analyses showed that the combination of CHMs with donepezil led to significant improvement in the MMSE score(Z=9.45;P<0.00001;weighted mean difference[WMD]=2.68,95%confidence interval[CI]:2.12-3.24)and a significant decrease in the ADAS-Cog score(Z=5.53;P<0.00001;WMD=-3.79;95%CI:-5.13--2.44).Safety evaluation demonstrated that these combination treatments relieved adverse events such as insomnia(risk ratio[RR]=0.20,95%CI:0.06-0.68;P=0.01)and hive(RR=0.10;95%CI:0.01-0.73;P=0.02).Conclusions:The combination of CHMs with a chemical drug like donepezil led to significant improvements in patient cognition as well as a better safety profile when compared to the application of a chemical drug alone.

关 键 词：Alzheimer's disease Chinese herbal medicine DONEPEZIL MEMANTINE META-ANALYSIS randomized controlled trials RIVASTIGMINE 

分 类 号：R749.16[医药卫生—神经病学与精神病学]