主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2019, Vol. 42 ›› Issue (8): 667-672.doi: 10.3969/j.issn.1006-2157.2019.08.010

• 临床研究 • 上一篇    下一篇

清热解毒法治疗阿尔茨海默病的系统评价*

时晶1; 倪敬年1; 田金洲1#; 魏明清1; 张学凯1; 李婷1; 田浩林1; 黄强1; 梁俊杰1; 王永炎2   

  1. 1 北京中医药大学东直门医院 北京 100700;
    2 中国中医科学院中医临床基础医学研究所
  • 收稿日期:2019-02-11 出版日期:2019-08-30 发布日期:2019-09-04
  • 通讯作者: 田金洲,男,博士,主任医师,教授,博士生导师,主要研究方向:痴呆的中医药防治,E-mail:jztian@hotmail.com
  • 作者简介:时晶,女,博士,主任医师,博士生导师
  • 基金资助:
    *国家自然科学基金资助项目(No.81473518,No.81573824),国家中医管理局中医临床研究基地资助项目(No.JDZX2015297),教育部引智计划资助项目(No.B08006),北京市科委研发资助项目(No.Z151100003815021),首都卫生发展科研专项资助项目(No.2016-4-4193),中国工程院咨询研究资助项目(No.2017-ZD-06)

A systematic review on heat-clearing and toxicity-removing therapy for Alzheimer’s disease*

Shi Jing1, NI Jingnian1, Tian Jinzhou1#, Wei Mingqing1, Zhang Xuekai1, Li Ting1, Tian Haolin1, Huang Qiang1, Liang Junjie1, Wang Yongyan2   

  1. 1 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;
    2 Institute of Chinese Basic Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2019-02-11 Online:2019-08-30 Published:2019-09-04
  • Contact: Prof. Tian Jinzhou, Ph. D., Chief Physician, Doctoral supervisor, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang Street, Dongcheng District, Beijing 100700. E-mail:jztian@hotmail.com

摘要: 目的 系统评价中药清热解毒法(黄连解毒汤)治疗阿尔茨海默病(AD)的疗效及安全性。方法 检索CNKI、万方、PubMed等数据库,筛选清热解毒法治疗痴呆的临床随机对照试验,检索时间为自建库至2019年5月22日,采用Jadad量表对研究质量进行评价,使用Cochrane协作网RevMan 5.3对清热解毒中药治疗痴呆的疗效进行Meta分析,计算风险比(relative risk,RR)、简易精神状态检查(mini-mental state examination, MMSE)及日常生活能力(activities of daily living,ADL)等均数差。结果 共纳入6篇随机对照试验,包括试验组344例AD患者,对照组328例患者。Meta分析结果显示,与对照组相比,清热解毒中药具有更高的临床改善率(RR=1.27,95%CI:1.08~1.50,I2=0%,P=0.004),组间MMSE具有显著差异(MD=2.69,95%CI:2.13~3.26,I2=84%,P<0.000 01)。此外,清热解毒法改善了AD的ADL(MD=-3.40,95%CI:-4.92~-1.87,I2=59%,P<0.000 01)。结论 清热解毒法治疗AD痴呆安全有效,可改善认知功能和日常生活能力,更倾向用于伴精神行为症状的中晚期患者。

关键词: 清热解毒, 阿尔茨海默病, 系统评价

Abstract: Objective To review systematically the curative effect and safety of heat-clearing and toxicity-removing therapy [Huanglian Jiedu Tang (Coptis Root Removing Toxicity Decoction)] on Alzheimer’s disease (AD). Methods The databases of CNKI, WanFang Data and PubMed were retrieved for screening clinical randomized controlled trials (RCTs) about AD treatment with heat-clearing and toxicity-removing therapy from database establishment time to May 22, 2019. The quality of the RCTs was reviewed by applying Jadad scale, and curative effect of Chinese medicinals with effects of clearing heat and removing toxicity was given a Meta-analysis by using RevMan 5.3 software from Cochrane Library. The mean differences of relative risk (RR), mini-mental status examination (MMSE) and activities of daily living (ADL) were calculated. Results There were totally 6 RCTs enclosed and 344 AD cases in test group and 328 in control group. The results of Meta-analysis showed that the clinical improvement rate was higher in test group than that in control group (RR=1.27, 95%CI: 1.08-1.50,I2=0%, P=0.004), and MMSE had significant difference between 2 groups (MD=2.69, 95%CI: 2.13-3.26, I2=84%, P<0.000 01). In addition, heat-clearing and toxicity-removing therapy improved ADL in AD patients (MD=-3.40, 95%CI: -4.92~-1.87, I2=59%, P<0.000 01). Conclusion The heat-clearing and toxicity-removing therapy is safe and effective in AD treatment, and can improve patients’ cognitive function and ADL. It tends to be used in AD patients complicated by behavioral and psychological symptoms in moderate or advanced stages.

Key words: clearing heat and removing toxicity, Alzheimer’s disease, systematic review

中图分类号: 

  • R277.7