| Objective: To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of cognitive dysfunction caused by cerebrovascular disease,and provide a theoretical basis for clinical selection of traditional Chinese medicine to treat cognitive dysfunction caused by cerebrovascular disease.Methods: Search and collect recent databases by searching VIP,China Knowledge Network(CNKI),Wanfang Digital Journal Group(WF),China Biomedical Document Service System(CBM),Pub Med,Cochrane Library,and EMbase.Ten years of randomized controlled clinical research literature on the treatment of cognitive dysfunction caused by cerebral small vessel disease with traditional Chinese medicine,as of January 2021.Two professional researchers screened the literature according to the inclusion and exclusion criteria set in this study,evaluated the quality of the included literature,and extracted relevant data from the literature.Through the application of Revman5.3 software,meta-analysis was performed on the effective rate,TCM syndrome score,Mo CA score,MMSE score,ADL score,Hcy,and adverse reactions in patients with cognitive dysfunction caused by cerebrovascular disease caused by traditional Chinese medicine.Results: In the end,18 relevant literatures of equivalent quality were included in the study.The number of cases in the literature comprehensive study was 1449.The Revman5.3 software was used for data integration analysis,heterogeneity test,combined effect size,etc.,and finally the forest was drawn.Figure,evaluation of the results of the Meta analysis.Meta analysis results show:(1)In the control of the traditional Chinese medicine group and the basic medication group,the Mo CA score: the combined effect size result is shown as(WMD=3.04,95%CI(2.10,3.97),P<0.00001),indicating that there are differences between the groups The statistical significance indicates that the traditional Chinese medicine group is more helpful to the improvement of the Mo CA score than the basic medication group.MMSE score: The combined effect size result is shown as(WMD=2.87,95%CI(1.53,4.21),P<0.0001),the test result is statistically significant,that is,the traditional Chinese medicine group can improve the MMSE score better than the control group.ADL score:The combined effect size result is shown as(WMD=10.22,95%CI(2.10,18.34),P=0.01),indicating that the difference between the two groups is statistically significant,that is,the traditional Chinese medicine group is better than the basic medication in improving the ADL score group.Adverse reactions: The combined effect size result is shown as(OR=3.07,95%CI(0.48,19.78),P=0.24),indicating that the difference between the two groups is not statistically significant,that is,the treatment of the traditional Chinese medicine group and the basic medication group adverse reactions There is no significant difference in the situation.(2)In the comparison between the traditional Chinese medicine group and the western medicine group: the traditional Chinese medicine group and the western medicine group: TCM syndrome integral: the combined effect size result is shown as(WMD=-3.79,95%CI(-6.68,-1.50),P=0.001),indicating The difference between the two groups is statistically significant,that is,the traditional Chinese medicine group is better than the western medicine group in reducing the TCM syndrome score.Mo CA score: the combined effect size is shown as(WMD=1.59,95%CI(0.06,3.12),P=0.04),indicating that the difference between the two groups is statistically significant,that is,the traditional Chinese medicine group is better than the Mo CA score Western medicine group.MMSE score: The combined effect size result is shown as(WMD=0.40,95%CI(-0.42,1.22),P=0.34),indicating that the difference between the two groups is not statistically significant,that is,the traditional Chinese medicine group is better than Western medicine in improving the MMSE score There is no significant difference between the groups.ADL: The combined effect size result is shown as(WMD=-1.96,95%CI(-4.94,1.03),P=0.20),indicating that the difference between the two groups is not statistically significant,that is,the Chinese medicine group is better than Western medicine group in improving the ADL score Compared with no obvious advantage.Hcy: The combined effect size result is shown as(WMD=-0.72,95%CI(-5.07,3.63),P=0.75),indicating that the difference between the two groups is not statistically significant,that is,the traditional Chinese medicine group is comparable to western medicine group in reducing Hcy.There is no obvious advantage.Adverse reactions: the combined effect size result is shown as(OR=1.54,95%CI(0.25,9.46),P=0.64),indicating that the difference between the two groups is not statistically significant,that is,the occurrence of the traditional Chinese medicine group and the western medicine group during the treatment The adverse events are comparable.(3)Traditional Chinese medicine combined with western medicine group compared with western medicine group: according to the effective rate evaluated in "Diagnosis,Syndrome Differentiation and Efficacy Judgment Criteria for Vascular Dementia",the combined effect size result is(OR=3.53,95%CI(1.69,7.35),P=0.0008)),indicating that the difference between the two groups is statistically significant,that is,the treatment efficiency of the traditional Chinese medicine combined with western medicine group is better than that of the western medicine group only.Judging by the treatment "Guiding Principles of Chinese New Drug Clinical Research",the combined effect size result is shown as(OR=2.66,95%CI(1.53,4.62),P=0.0005),indicating that the difference is statistically significant,that is,the Chinese medicine combined with western medicine group The effective rate of treatment is better than that of the western medicine group only.Reduce TCM syndrome score: The combined effect size result is shown as(WMD=-3.05,95%CI(-6.61,-0.51),P=0.09),indicating that the difference between the two groups is not statistically significant,that is,the Chinese medicine combined with western medicine group There is little difference with the western medicine group in reducing the scores of TCM syndromes.Improve Mo CA score: The combined effect size result is shown as(WMD=2.30,95%CI(1.50,3.09),P<0.00001),indicating that the difference between the two groups is statistically significant,that is,the traditional Chinese medicine combined with western medicine group improves the Mo CA score Better than the western medicine group.In improving the MMSE score: the combined effect size result is shown as(WMD=1.70,95%CI(1.06,2.34),P<0.00001),indicating that the difference between the two groups is statistically significant,that is,the Chinese medicine combined with western medicine group is improving the MMSE score Superior to the western medicine group.In improving the ADL score,the combined effect size result showed(WMD=2.76,95%CI(-1.55,7.08),P=0.21),indicating that the difference between the two groups was not statistically significant,that is,the Chinese medicine combined with western medicine group is improving Compared with western medicine group,ADL score has no obvious advantage.In reducing Hcy: the combined effect size result is shown as(WMD=-3.38,95%CI(-3.93,-2.84),P < 0.00001),indicating that the difference between the two groups is statistically significant,that is,the traditional Chinese medicine combined with western medicine group Compared with western medicine,reducing Hcy has obvious advantages.Adverse reactions:The combined effect size result is shown as(OR=1.35,95%CI(0.29,6.21),P=0.70),indicating that the difference between the two groups is not statistically significant,that is,the treatment of the traditional Chinese medicine combined with the western medicine group and the western medicine group There was no significant difference in the adverse effects of treatment.Conclusion: This study shows that the traditional Chinese medicine group is better than the basic medication group in improving the Mo CA score,MMSE score,and ADL score;the traditional Chinese medicine group is better than the western medicine group in improving the Mo CA score and reducing the TCM syndrome score;at the same time,the traditional Chinese medicine combined with the western medicine group is better Efficiency,improvement of Mo CA score,improvement of MMSE score,and reduction of Hcy are superior to the western medicine group.In terms of adverse reactions,the differences between the two groups of the four groups were not statistically significant.Therefore,traditional Chinese medicine and basic medicine or western medicine have certain advantages in the treatment of patients with cognitive dysfunction caused by cerebrovascular disease,and their safety is better.At the same time,the combination of traditional Chinese medicine and western medicine has obvious curative effect compared with western medicine.Traditional Chinese medicine has its unique advantages and can be applied to the clinical treatment of patients with cognitive dysfunction caused by cerebral small vessel disease. |
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