Meta - Analysis Of Treatment Of Alzheimer 's Disease With Traditional Chinese Medicine

Objective:Making a systematic review on traditional Chinese medicine (TCM) and Kidney-nourishing and activating blood circulation formula compared with donepezil in curing Alzheimer disease(AD) in order to evaluate the efficacy and safety of traditional Chinese medicine for kidney-nourishing and activating blood circulation in the treatment of AD, compared with donepezil.Method:Abide by the Cochrane handbook, searching Pubmed, CBMdisc, and using the free word in CNKI, Wanfang, VIP from the database established till 2015.12.All the randomized controlled trials by using TCM on treating AD was searched.Diagnosed with AD according to NINCDS-ADRDA or DSM-IV or NIA-AA. Controlled group:Give oral administration of donepezil 5mg before sleeping everyday. TCM group:Give oral administration of traditional Chinese medicine for research one and kidney-nourishing and activating blood circulation formula for research two by each hospital pharmacy,0.5 to 1 hour after breakfast and supper,1 bag each time, twice or third a day. Using MMSE and ADL as primary outcome measurement.Using Rveman 5.3 to evaluate the heterogeneity of data, we calculated the relative risk(RR) along with the 95% confidence interval(CI) and mean difference(MD) for continuous outcomes. Also we assessed the risk of bias and used JADAD to measure the quality of studies. Results:Finally for research one Six studies involving 596 AD patients were included in this meta-analysis.No significant difference was observed on cognitive improvement and daily abilities of patients according to MMSE scale(MD:0.69,95% CI:[-0.17,1.56]) and ADL scale (MD:0.94,95% CI:[-1.54,3.43]).And there were no significant difference either according to the different state of illness,the mean difference for light-moderate AD patients is(MD:0.62,95% CI:[-2.99,4.23]) on 24 weeks and (MD:-0.73,95% CI:[-5.02,3.56]) on 48 weeks.As for severe AD patients (MD:3.13,95%CI:[-6.92,13.18]) on 24 weeks and (MD:4.23,95%CI:[-6.38,14.84]) on 48 weeks.By using heart-regulating TCM as experimental group compared with donepezil(MD:-1.50,95% CI:[-3.08,0.08]).But the kidney-tonifying TCM group shows no obvious effect compared with donepezil(MD:-1.92,95% CI:[-3.50,-0.33]).As for the side effect, TCM showed advantage on AD patients. For research two only 3 reports met the requirements,204 patients were included.MMSE:Heterogeneity:P=0.04, I2=69%,Total(95%CI)MD1.40[-0.04,2.85],Z=1.90(P=0.06);ADL:Heterogeneity:P=0.29 I2=12%,Total(95%CI)MD-3.01[-4.82,-1.19],Z=3.25(P=0.001);TCM efficacy:Heterogeneity: P=0.35, I2=0%, Total (95%CI) OR 1.63[0.82,3.26], Z=1.39 (P=0.16).Conclusion:The result of review shows that TCM and Kidney-nourishing and activating blood circulation formula can improve self-care ability of AD patients and compared to donepezil group, there is no different on improvement of cognitive ability and Chinese effect evaluation. At the same time, we should be careful with the result, because of the low quality of researches, expect more high quality clinical trials were done to give the doctor more and better ways to cure AD.