BOOK
Evidence-based Clinical Chinese Medicine - Volume 8: Alzheimer's Disease
Xue Charlie Changli | Lu Chuanjian | May Brian
(2018)
Additional Information
Book Details
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Contents | xxv | ||
| Disclaimer | v | ||
| Foreword | vii | ||
| Purpose of The Monograph | xi | ||
| Authors and Contributors | xv | ||
| Members of Advisory Committee and Panel | xvii | ||
| Professor Charlie Changli Xue, PhD | xix | ||
| Professor Chuanjian Lu, MD | xxi | ||
| Acknowledgements | xxiii | ||
| List of Figures | xxxvii | ||
| List of Tables | xxxix | ||
| 1. Introduction to Alzheimer’s Disease | 1 | ||
| Definition of Alzheimer’s Disease | 1 | ||
| Clinical Presentation | 2 | ||
| Epidemiology of Dementia and Alzheimer’s Disease | 3 | ||
| Burden of Alzheimer’s Disease | 4 | ||
| Risk Factors | 4 | ||
| Pathological Processes | 5 | ||
| Diagnosis | 6 | ||
| Assessment | 7 | ||
| Differential Diagnosis | 7 | ||
| Management | 9 | ||
| Pharmacological Interventions | 10 | ||
| Non-pharmacological Interventions | 13 | ||
| Prognosis | 14 | ||
| Limitations of Conventional Therapy | 14 | ||
| Prevention | 15 | ||
| References | 17 | ||
| 2. Alzheimer’s Disease in Chinese Medicine | 27 | ||
| Introduction | 27 | ||
| Aetiology and Pathogenesis | 28 | ||
| Syndrome Differentiation and Treatments | 29 | ||
| Oral Chinese Herbal Medicine Treatment Based on Syndrome | 30 | ||
| Differentiation | 30 | ||
| Deficiency of Sea of Marrow 髓海不足证 | 30 | ||
| Spleen and Kidney Dual Deficiency 脾肾两虚证 | 31 | ||
| Deficiency of Qi and Blood 气血亏虚证 | 31 | ||
| Turbid Phlegm Obstructing the Orifices 痰浊蒙窍证 | 32 | ||
| Blood Stasis Obstructing the Brain Collaterals 瘀阻脑络证 | 33 | ||
| Heart and Liver Fire 心肝火旺证 | 33 | ||
| Endogenous Toxins Damaging the Brain Collaterals 毒损脑络证 | 34 | ||
| Single Herb Formulae | 35 | ||
| Ren shen Porridge 人参粥 | 35 | ||
| Ci wu jia Powder 刺五加粉 | 35 | ||
| Jiao gu lan Powder 绞股蓝粉 | 35 | ||
| Acupuncture and Related Therapies | 36 | ||
| Other Management Strategies | 38 | ||
| Dietary Therapy | 38 | ||
| Prognosis | 39 | ||
| References | 39 | ||
| 3. Classical Chinese Medicine Literature | 41 | ||
| Introduction | 41 | ||
| Search Terms | 42 | ||
| Procedures for Search, Data Coding and Data Analysis | 44 | ||
| Search Results | 45 | ||
| Definitions and Descriptions of Memory Impairment and Dementia | 46 | ||
| Citations Relating to the Aetiology of Memory Loss and Dementia\r | 48 | ||
| Chinese Herbal Medicine | 51 | ||
| Frequency of Treatment Citations by Dynasty | 51 | ||
| Treatment with Chinese Herbal Medicine | 53 | ||
| Most Frequent Formulae in Possible Alzheimer’s Disease Citations | 53 | ||
| Most Frequent Herbs in Possible Alzheimer’s Disease Citations | 56 | ||
| Most Frequent Formulae in Likely Alzheimer’s Disease Citations | 58 | ||
| Most Frequent Herbs in Likely Alzheimer’s Disease Citations | 62 | ||
| Discussion of Chinese Herbal Medicine for Alzheimer’s Disease | 64 | ||
| Acupuncture and Related Therapies | 66 | ||
| Frequency of Treatment Citations by Dynasty | 66 | ||
| Frequency of Acupuncture Points | 68 | ||
| Discussion of Acupuncture and Related Therapies for Alzheimer’s Disease | 69 | ||
| Classical Literature in Perspective | 70 | ||
| References | 72 | ||
| 4. Methods for Evaluating Clinical Evidence | 75 | ||
| Introduction | 75 | ||
| Search Strategy | 76 | ||
| Inclusion Criteria | 77 | ||
| Participants | 78 | ||
| Interventions | 78 | ||
| Comparators in Controlled Trials | 79 | ||
| Settings | 80 | ||
| Exclusion Criteria | 80 | ||
| Study Type | 80 | ||
| Participants | 80 | ||
| Interventions | 81 | ||
| Comparators in Controlled Trials | 81 | ||
| Outcomes | 81 | ||
| Mini-Mental State Examination | 81 | ||
| Hasegawa’s Dementia Scale | 83 | ||
| Alzheimer’s Disease Assessment Scale Cognitive Subscale | 83 | ||
| Montreal Cognitive Assessment | 84 | ||
| Cognitive Capacity Screening Examination | 84 | ||
| Wechsler Memory Scale | 84 | ||
| Clinical Dementia Rating | 84 | ||
| Global Deterioration Scale | 85 | ||
| Blessed Dementia Scale and Blessed Behaviour Scale | 85 | ||
| Activities of Daily Living | 85 | ||
| Functional Activities Questionnaire | 86 | ||
| Neuropsychiatric Inventory | 86 | ||
| Alzheimer’s Disease Assessment Scale Non-Cognitive Subscale | 86 | ||
| Behavioral Pathology in Alzheimer’s Disease Rating Scale | 87 | ||
| Cornell Scale for Depression in Dementia | 87 | ||
| Hamilton Depression Rating Scale | 87 | ||
| Cohen-Mansfield Agitation Inventory | 87 | ||
| Risk of Bias Assessment | 88 | ||
| Statistical Analyses | 89 | ||
| Assessment Using GRADE | 91 | ||
| References | 92 | ||
| 5. Clinical Evidence for Chinese Herbal Medicine | 97 | ||
| Introduction | 97 | ||
| Previous Systematic Reviews | 98 | ||
| Identification of Clinical Studies | 98 | ||
| Oral Chinese Herbal Medicine | 100 | ||
| Randomised Controlled Trials of Oral Chinese Herbal Medicine | 100 | ||
| Risk of Bias | 104 | ||
| Results of Meta-Analyses of Outcome Measures | 105 | ||
| Mini-Mental State Examination | 105 | ||
| Chinese herbal medicine versus inactive controls | 105 | ||
| Chinese herbal medicine versus pharmacotherapy | 106 | ||
| Chinese herbal medicine versus donepezil | 106 | ||
| Chinese herbal medicine versus huperzine | 107 | ||
| Chinese herbal medicine versus piracetam or aniracetam | 107 | ||
| Chinese herbal medicine versus other pharmacotherapies | 108 | ||
| Sub-group and sensitivity analyses | 108 | ||
| Integrative Chinese herbal medicine | 109 | ||
| Sub-group and sensitivity analyses | 112 | ||
| Summary for Mini-Mental State Examination | 113 | ||
| Hasegawa’s Dementia Scale | 114 | ||
| Chinese herbal medicine versus pharmacotherapy | 114 | ||
| Integrative Chinese herbal medicine | 116 | ||
| Summary for Hasegawa’s Dementia Scale | 116 | ||
| Alzheimer’s Disease Assessment Scale Cognitive Subscale | 116 | ||
| Chinese herbal medicine versus inactive controls | 116 | ||
| Chinese herbal medicine versus pharmacotherapy | 117 | ||
| Integrative Chinese herbal medicine | 119 | ||
| Summary for Alzheimer’s Disease Assessment Scale Cognitive Subscale | 120 | ||
| Activities of Daily Living | 121 | ||
| Chinese herbal medicine versus inactive controls | 121 | ||
| Chinese herbal medicine versus pharmacotherapy | 122 | ||
| Studies using ‘lower is better’ activities of daily living scales | 122 | ||
| Sub-group and sensitivity analyses for ‘lower is better’ group | 122 | ||
| Studies using ‘higher is better’ activities of daily living scales | 124 | ||
| Integrative Chinese herbal medicine | 125 | ||
| Sub-group analyses for ‘lower is better’ group | 126 | ||
| Functional Activities Questionnaire | 127 | ||
| Summary for Activities of Daily Living scales | 127 | ||
| Other Outcome Measures Reported in Randomised Controlled Trials | 128 | ||
| Montreal Cognitive Assessment | 129 | ||
| Cognitive Capacity Screening Examination | 129 | ||
| Memory Quotient | 129 | ||
| Global Deterioration Scale | 129 | ||
| Blessed Dementia Scale | 130 | ||
| Effective Rate | 130 | ||
| Behavioural and Psychological Symptoms of Dementia | 130 | ||
| Neuropsychiatric Inventory | 130 | ||
| Alzheimer’s Disease Assessment Scale Non-Cognitive Subscale | 131 | ||
| Behavioural Pathology in Alzheimer’s Disease Rating Scale | 132 | ||
| Hamilton Depression Rating Scale | 132 | ||
| Cohen-Mansfield Agitation Inventory | 132 | ||
| Summary for measures of Behavioural and Psychological Symptoms | 132 | ||
| GRADE for Main Chinese Herbal Medicine Comparisons | 132 | ||
| Oral Chinese Herbal Medicine versus Inactive Control | 133 | ||
| Oral Chinese Herbal Medicine versus Donepezil | 134 | ||
| Integrative Medicine: Oral Chinese Herbal Medicine Combined with Donepezil versus Donepezil\r | 135 | ||
| Randomised Controlled Trial Evidence for Individual Oral Chinese Herbal Formulae | 136 | ||
| Chinese Herbal Formulae versus Pharmacotherapy | 136 | ||
| Mini-Mental State Examination | 136 | ||
| Alzheimer’s Disease Assessment Scale Cognitive Subscale | 139 | ||
| Activities of Daily Living | 139 | ||
| Integrative Chinese Herbal Medicine | 140 | ||
| Mini-Mental State Examination | 140 | ||
| Alzheimer’s Disease Assessment Scale Cognitive Subscale | 140 | ||
| Activities of Daily Living ‘Lower is Better’ | 140 | ||
| Summary and Conclusions for Meta-Analyses of Individual Formulae\r | 142 | ||
| GRADE for Individual Formulae | 143 | ||
| Fu fang hai she jiao nang versus Donepezil | 144 | ||
| Yi zhi jian nao ke li versus Donepezil | 144 | ||
| Fu fang hai she jiao nang Combined with Donepezil versus Donepezil | 145 | ||
| Yi zhi jian nao ke li Combined with Donepezil versus Donepezil | 146 | ||
| Frequently Reported Herbs in Meta-Analyses of Cognitive Outcomes | 146 | ||
| Chinese Herbal Medicine versus Donepezilfor Cognitive Outcome Measures | 146 | ||
| Integrative Chinese Herbal Medicine Plus Donepezil versus Donepezil for Cognitive Outcome Measures | 147 | ||
| Controlled Clinical Trials of Oral Chinese Herbal Medicine | 149 | ||
| Mini-Mental State Examination | 150 | ||
| Hasegawa’s Dementia Scale | 151 | ||
| Alzheimer’s Disease Assessment Scale Cognitive Subscale | 151 | ||
| Activities of Daily Living ‘lower is better’ | 152 | ||
| Other Outcomes | 152 | ||
| Clinical Evidence from Non-controlled Studies of Oral Chinese Herbal Medicine | 153 | ||
| Safety of Chinese Herbal Medicine for Alzheimer’s Disease | 155 | ||
| Clinical Evidence for Commonly Used Oral Formulae | 155 | ||
| Summary of the Clinical Evidence for Oral Chinese Herbal Medicine | 156 | ||
| References | 159 | ||
| 6. Pharmacological Actions of the Common Herbs | 173 | ||
| Introduction | 173 | ||
| Experimental Studies on Shi chang pu 石菖蒲 | 174 | ||
| Experimental Studies on Fu ling 茯苓 | 175 | ||
| Experimental Studies on Di huang 地黄 | 177 | ||
| Experimental Studies on Yuan zhi 远志 | 178 | ||
| Experimental Studies on Gan cao 甘草 | 179 | ||
| Experimental Studies on Chuan xiong 川芎 | 180 | ||
| Experimental Studies on Dang gui 当归 | 181 | ||
| Experimental Studies on Ren shen 人参 | 182 | ||
| Experimental Studies on He shou wu 何首乌 | 183 | ||
| Experimental Studies on Yin yang huo 淫羊藿 | 184 | ||
| Summary of Evidence from In-Vivo and In-Vitro Studies | 185 | ||
| References | 185 | ||
| 7. Clinical Evidence for Acupuncture and Related Therapies | 193 | ||
| Introduction | 193 | ||
| Previous Systematic Reviews | 194 | ||
| Identification of Clinical Studies | 194 | ||
| Studies of Acupuncture/Moxibustion | 196 | ||
| Randomised Controlled Trials of Acupuncture/Moxibustion | 196 | ||
| Syndromes | 197 | ||
| Frequently Used Points in Randomised Controlled Trials of Acupuncture/Moxibustion | 197 | ||
| Risk of Bias | 198 | ||
| Acupuncture versus No Treatment | 199 | ||
| Acupuncture versus Psychotherapy | 199 | ||
| Acupuncture versus Pharmacotherapy | 199 | ||
| Mini-Mental State Examination | 200 | ||
| Hasegawa Dementia Scale | 201 | ||
| Activities of Daily Living | 202 | ||
| Functional Activities Questionnaire | 203 | ||
| Integrative Acupuncture versus Pharmacotherapy | 204 | ||
| Frequently Reported Acupuncture Points in Meta-analyses | 204 | ||
| Assessment of Acupuncture Using GRADE | 205 | ||
| Acupuncture versus Donepezil | 206 | ||
| Clinical Evidence from Non-Randomised Controlled Trials | 206 | ||
| Clinical Evidence from Non-Controlled Studies of Acupuncture | 207 | ||
| Safety of Acupuncture/Moxibustion | 208 | ||
| Studies of Scalp Acupuncture | 208 | ||
| Mini-Mental State Examination | 208 | ||
| Montreal Cognitive Assessment | 209 | ||
| Activities of Daily Living | 209 | ||
| Frequently Reported Scalp Acupuncture Zones in Meta-analyses Showing Benefits for Mini-Mental State Examination and Activities of Daily Living | 210 | ||
| Assessment of Scalp Acupuncture Using GRADE | 211 | ||
| Clinical Evidence from Controlled Clinical Trials and Non-Controlled Studies | 212 | ||
| Safety of Scalp Acupuncture | 212 | ||
| Clinical Evidence for Commonly Used Acupuncture Interventions | 212 | ||
| Summary of Clinical Evidence for Acupuncture and Related Therapies | 213 | ||
| References | 215 | ||
| 8. Clinical Evidence for Other Chinese Medicine Therapies | 219 | ||
| Introduction | 219 | ||
| Previous Systematic Reviews | 220 | ||
| Summary of the Clinical Evidence | 220 | ||
| Chinese Exercise Therapy | 222 | ||
| Risk of Bias | 222 | ||
| Results | 222 | ||
| Behavioral Pathology in Alzheimer Disease Rating Scale | 222 | ||
| Safety of Chinese Exercise Therapy | 223 | ||
| Chinese Remedial Massage Therapy | 223 | ||
| Results | 223 | ||
| Safety of Chinese Remedial Massage Therapy | 224 | ||
| Clinical Evidence for Other Commonly Used Chinese Medicine Therapies | 224 | ||
| Summary of Clinical Evidence for Other Chinese Medicine Therapies | 224 | ||
| References | 225 | ||
| 9. Clinical Evidence for Combination Therapies | 229 | ||
| Introduction | 229 | ||
| Randomised Controlled Trials of Combination Therapies | 229 | ||
| Risk of Bias | 231 | ||
| Clinical Evidence for Oral Chinese Herbal Medicine Plus Acupuncture/Moxibustion Therapy | 232 | ||
| Frequently Used Herbs and Acupuncture Points | 232 | ||
| Mini-Mental State Examination | 234 | ||
| Revised Hasegawa Dementia Scale | 235 | ||
| Activities of Daily Living | 235 | ||
| Integrative Medicine: Chinese Herbal Medicine Plus Acupuncture Plus Pharmacotherapy | 236 | ||
| Chinese Herbal Medicine Diet Therapy Plus Moxibustion versus Pharmacotherapy | 236 | ||
| Chinese Herbal Medicine Plus Moxibustion Plus Pharmacotherapy versus Pharmacotherapy | 237 | ||
| Chinese Herbal Medicine Plus Tai Chi Plus Pharmacotherapy versus Pharmacotherapy | 237 | ||
| Safety of Combination Therapies for Alzheimer’s Disease | 237 | ||
| Clinical Evidence for Commonly Used Interventions | 237 | ||
| Summary of the Evidence for Combination Therapies | 238 | ||
| References | 239 | ||
| 10. Summary and Conclusions | 241 | ||
| Introduction | 241 | ||
| Chinese Medicine Syndrome Differentiation | 242 | ||
| Chinese Herbal Medicine | 244 | ||
| Chinese Herbal Medicine Formulae in Key Clinical Guidelines and Textbooks, Classical Literature and Clinical Studies | 245 | ||
| Acupuncture and Related Therapies | 249 | ||
| Acupuncture Points used in Key Clinical Guidelines and Textbooks, Classical Literature and Clinical Studies | 251 | ||
| Other Chinese Medicine Therapies | 255 | ||
| Other Chinese Medicine Therapies in Key Clinical Guidelines and Textbooks, Classical Literature and Clinical Studies | 255 | ||
| Limitations of the Evidence | 257 | ||
| Implications for Practice | 260 | ||
| Implications for Research | 263 | ||
| References | 265 | ||
| Glossary | 269 | ||
| Index | 277 |