[Treatment of Alzheimer disease: an evidence-based review].
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.
Chi
Jung-fang
JF
Laboratory of Cell and Biochemistry, Beijing University of Chinese Medicine, Beijing 100029, China. jungfangchi@yahoo.com
Niu
Jian-zhao
JZ
Xu
Shu-qiang
SQ
Li
Jian
J
Wang
Ji-feng
JF
Liu
Jian-ping
JP
D000544:Alzheimer Disease / Q000188:drug therapy*; D004358:Drug Therapy / Q000379:methods; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000379:methods; D008517:Phytotherapy; D016032:Randomized Controlled Trials as Topic
D004365:Drugs, Chinese Herbal