中医药治疗轻度认知障碍的系统评价再评价＊

目的 选取中医药治疗轻度认知障碍的Meta分析和系统评价（MA/SR）,评价纳入文献的方法学和证据质量,以期为中医药治疗MCI提供临床参考。方法 选取万方数据库（Wanfang）、中国知网（CNKI）、维普（VIP）、中国生物医学文献数据库（CBMdisc）、Embase、PubMed、Cochrane Library、Web of Science 8个数据库对建库至2021年9月30日关于中医药治疗轻度认知障碍的MAs/SRs进行检索,筛选后,运用AMSTAR 2工具对纳入的MAs/SRs的方法学质量进行评价,同时使用GRADE系统对纳入文献中的证据质量进行评价分级。结果 本文共检索到相关文献160篇,最终纳入19篇。AMSTAR 2的结果显示,在纳入的19篇MAs/SRs中,有2篇文献为中等质量研究,有6篇文献为低质量研究,有11篇文献为极低质量研究。GRADE评级显示,中医药治疗轻度认知障碍的MAs/SRs具有较低的证据质量。通过GRADE进行质量分级后的结果显示,有3个结局指标为中质量,有24个结局指标为低质量,有24个结局指标为极低质量,无高质量结局指标。结论 根据纳入的MAs/SRs结果显示,中医药治疗轻度认知障碍是具有疗效且安全的,但目前相关研究的方法学质量和证据质量级别都比较低,主要原因在原始文献的质量有待提升。

Traditional Chinese Medicine for the Treatment of Mild Cognitive Impairment: an Overview of Systematic Reviews

Objective The Meta-analysis/Systematic review (MAs/SRs) of Chinese medicine treatment of mild cognitive impairment (MCI) aims to evaluate the methodology and evidence quality of the included literature, thereby providing a clinical reference for Chinese medicine treatment of MCI.Methods MAs/SRs on the treatment of mild cognitive impairment by traditional Chinese medicine from the creation of databases to September 30, 2021 were retrieved from 8 databases, including Wanfang, CNKI, VIP, CBM, Embase, PubMed, Cochrane Library, and Web of Science. After screening, the methodological quality of the included MAs/SRs was evaluated by AMSTAR 2; also, the quality of evidence in the included literature was evaluated and graded by GRADE system. As a result, a total of 160 relevant articles were retrieved in this paper, among which 19 articles were included. AMSTAR 2 results showed that 2 out of the 19 articles were fair average quality, 6 articles were low quality, and the remaining 11 articles were very low quality. GRADE rating showed that the MAs/SRs of Chinese medicine in the treatment of mild cognitive impairment is not well evidenced. The results of quality grading by GRADE showed that 3 outcome indicators were fair average quality, 24 indicators were low quality, and 24 indicators were very low quality. There were no high-quality outcome indicators.Conclusion It can be concluded that according to the included MAs/SRs results, TCM treatment of mild cognitive impairment is effective and safe, but the methodology and evidence of relevant studies are poor in quality at present, mainly due to the original literature to be improved.