Treatment of Alzheimer disease: an evidence-based review / 中西医结合学报

ABSTRACT

OBJECTIVE: The purpose of this research was mainly two-fold first, to get an understanding of current researches conducted on Alzheimer disease in China; second, to systematically evaluate and compare Alzheimer's treatment delivered by traditional Chinese medicine (TCM) and Western medicine. METHODS: Two steps were employed in this research. They were data collection and cleaning, followed by systemic review and qualitative analysis. The data were selected from the following two databases CNKI (http//www.cnki.net) and Wanfang Data (http//www.wanfangdata.com.cn). Inclusion criteria were (1) Chinese literature; (2) Published between year 1994 and year 2004; (3) Using TCM as treatment and Western medicine as control; (4) Similar research purposes and methodology; (5) Subjects were diagnosed as Alzheimer disease. Descriptive analysis, homogeneity test, meta analysis, sensitivity analysis and subgroup analysis were performed in the second step. RESULTS: Supposing all qualified studies were of high quality, we got the following conclusion: the advantage of TCM was losing because of the newly-developed acetylcholinesterase inhibitors came in market. Moreover, the studies conducted after year 2002 were more homogeneous in comparison with those conducted in early years. Those studies using mini-mental status examination (MMSE) as outcome measurement were also more homogeneous than non-MMSE measurement groups. Combined odds ratio in comparative studies was 1.5 fold higher than that in experimental studies. Regarding to different outcome measurement, those studies using TCM assessment profile were 2.58(4.79/1.86) fold higher than those using MMSE as outcome measurement. CONCLUSIONS: After systemic literature search, we found that only 40 out of 2,403 studies met our inclusion criteria. Moreover, those qualified studies were of low quality. Therefore, the external validity of this study would be compromised. The solution to this would be to improve study quality by strengthening study design and carefully select more homogeneous subjects in terms of syndrome differentiation, by so doing, the results of meta analysis will be more convincing and easily recognized by international society.