The effectiveness and safety of Jihwang-eumja (Dihuang Yizi) compared to Western medications in patients with Alzheimer's disease: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Jihwang-eumja is reported to be effective in decreasing ß-amyloid expression and activating monoamine oxidase and acetylcholinesterase in rat models. This systematic review aims to evaluate the effectiveness of Jihwang-eumja in Alzheimer's disease compared to Western medications. METHODS: We searched Medline, Embase, CENTRAL, CINAHL, CNKI, ScienceON, KISS, and Kmbase. Randomized controlled trials comparing the effectiveness of Jihwang-eumja and Western medications on the cognition and the activities of daily living in Alzheimer's disease were included. The results were synthesized using meta-analysis. The risk of bias was evaluated using the Cochrane risk-of-bias tool, and the evidence level of each outcome was suggested using the GRADE system. RESULTS: A total of 165 studies were screened, and six were included in the systematic review and meta-analysis. A total of 245 and 240 participants were included in the intervention and comparison groups, respectively. The results showed that Mini-Mental State Examination was 3.19 (95%CI: 1.68-4.70) higher, and the standardized mean difference of activities of daily living was 1.13 (95%CI: 0.89-1.37) higher in the Jihwang-eumja group than in Western medications group. The included studies contained some concerns of the risk of bias, and the certainty of the evidence was considered moderate. CONCLUSION: Despite the small number of studies and high heterogeneity, we could verify the applicability of Jihwang-eumja for Alzheimer's disease.

Efficacy of Jihwangeumja (Dihuang Yinzi) on cognitive function and activities of daily living in patients with Alzheimer disease: A protocol for a systematic review and meta-analysis.

BACKGROUND: This systematic review protocol describes the methods proposed to evaluate the efficacy and safety of Jihwangeumja in patients with Alzheimer disease. METHODS: The following databases, PubMed, EMBASE, CENTRAL, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, National Digital Science Library, Korean Information Service System, and Korean Medical Database will be searched for relevant publications without language or publication status restrictions. Search terms will be based on "Alzheimer" for participants and "Jihwangeumja" or "Dihuang Yinzi" for interventions. Two researchers will independently extract the study data from the included studies and only randomized controlled trials will be included. The risk of bias will also be assessed independently by 2 researchers using the Cochrane risk of bias tool. We will use RevMan software random-effects and fixed-effect models for the assessment of heterogeneity and data synthesis. Any changes in the plan for documenting significant protocol amendments will require the researchers to have a revision agreement and register the international prospective register of systematic review modification. RESULTS: The treatment effect and safety will be measured by meta-analysis and the quality of the included studies will be reviewed. CONCLUSION: This systematic review will provide evidence regarding the efficacy and safety of Jihwangeumja. ETHICS AND DISSEMINATION: Ethical approval is not required because individual patient data will not be included in this paper. The study findings will be disseminated through conference presentations. OSF REGISTRATION: DOI: 10.17605/OSF.IO/HXA58.

Non-pharmacological interventions for patients with dementia: A protocol for a systematic review and meta-analysis.

BACKGROUND: This protocol for a systematic review describes the methods that will be used to evaluate the efficacy and safety of non-pharmacological interventions for patients with dementia. METHODS: We will search ALOIS, the specialized register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), without language or publication status restrictions. Additional separate searches will be run in many of the above six databases to ensure the most up-to-date results are retrieved.The study selection and data extraction will be performed independently by two authors and only randomized controlled trials will be included. The risk of bias will be assessed independently by two authors following the Cochrane Handbook for Systematic Reviews of Interventions. We will use RevMan software and random-effects models to assess the heterogeneity and data synthesis.If any plan for documenting important protocol amendments changes, the researchers will make a revision agreement and then register the modification on PROSPERO. CONCLUSION: Through this systematic review, a comprehensive understanding of current non-pharmacological interventions on dementia will be available. Meanwhile, it will provide basic evidence for further clinical research. ETHICS AND DISSEMINATION: Ethical approval is not required because no individual patient's data are included in this paper. This study will be disseminated through conference presentation. PROSPERO REGISTRATION NUMBER: CRD42019136435.