A Systematic Review Of Traditional Chinese Medicine In The Treatment Of Mild Cognitive Impairment

BackgroundsAmong a variety of clinical subtypes of mild cognitive impairment, aMCI is the most common one, the transition stage between normal ageing and senile dementia. Memory loss has been recognized as the main clinical manifestation of aMCI, with or without minor damages in complexly life abilities. The person who has aMCI is more likely to converse to Alzheimer Type Dementia, thus looking for effective treatments for aMCI is the key to kill the Alzheimer’s disease. However, no interventions have been proved effective. Recently, more and more trials report that the Chinese therapy would be the effective one, while the efficacy and safety of it has not been strongly proved.ObjectsBy systematically review randomized controlled trials of mild cognitive impairment which was treated with traditional Chinese medicine, estimate whether the decoctions can effectively reduce the rate of aMCI patients converse to Alzheimer’s dementia and improve the cognitive abilities of patients, and find the potential adverse effects of compounds for long-term use. It may provide powerful evidence for the effectiveness and safety of traditional Chinese medicine in the treatment of aMCI and guidance and reference for clinical research in this field.MethodsFirstly, pre-design inclusion criteria according to the objects of this review. Then search the database to collect literatures associated with randomized controlled trials of TCM in treating aMCI patients. During the second step, Pubmed, Embase, Cochrane Library, CNKI, CBM, VIP database and Wan Fang database was included. Extract studies met the inclusion criteria and get useful data from them. Before interpreting results and drawing conclusions, we still need to assess these studies for risk of bias. At last, using GRADEprofiler to evaluate the evidence level of the results.ResultsAmong the 1556 papers which was searched by the Internet, only 4 qualified was included at last. In the aspects of dementia conversion rate, per-protocol analysis showed RR(fixed)= 0.20,95%CI[0.06,0.68] and in the aspects of MMSE scores, RR(fixed)=2.69,95%CI[2.31, 3.06]. It showed that Chinese therapy can reduce the risk of conversion to AD for aMCI patients and improve their performance in MMSE scores. In addition, adverse reaction was reported in only one study. A volunteer in the placebo group felt sick, after had the oral liquid. No specific adverse reaction was found in people who received the treatment of traditional Chinese medicine. However, the evidence level of the results was not high.ConclusionsThe research shows that TCM is effective in the treatment of aMCI, without adverse drug reaction. More attention should be paid to the potential therapy. While, due to the small sample size and some flaws in the methodology of included studies, the evidence which the results provided was at a low level, more well designed randomized controlled trails are required.