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Autophagy plays a pro-apoptotic role in arsenic trioxide-induced cell death of liver cancer

Journal of Integrative medicine 2024年第3期22卷 295-302页

作者： Zhengting Deng Shufang Liang Guokai Huang Yuqian Wang Xiaoyu Tu Yani Zhang Shu Li Tao Liu Binbin Cheng Taizhou Hospital of traditional chinese medicine Nanjing University of Chinese MedicineTaizhou 225300Jiangsu ProvinceChina oncology department of traditional chinese medicine The First Affiliated Hospital of Naval Medical UniversityShanghai 200433China School of traditional chinese medicine Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina department of Gastroenterology Baoshan Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 201900China

Objective: The effects of arsenic trioxide(As2O3) on hepatocellular carcinoma have been documented widely. Autophagy plays dual roles in the survival and death of cancer cells. Therefore, we investigated the exact role of autophagy in As2O3-induced apoptosis in liver cancer ***: The viability of hepatoma cells was determined using the MTT assay with or without fetal bovine serum. The rate of apoptosis in liver cancer cells treated with As2O3was evaluated using flow cytometry, Hoechst 33258 staining, and TUNEL assays. The rate of autophagy among liver cancer cells treated with As2O3was detected using immunofluorescence, western blot assay and transmission electron ***: Upon treatment with As2O3, the viability of HepG2 and SMMC-7721 cells was decreased in a time-and dose-dependent manner. The apoptosis rates of both liver cancer cell lines increased with the concentration of As2O3, as shown by flow cytometry. Apoptosis in liver cancer cells treated with As2O3was also shown by the activation of the caspase cascade and the regulation of Bcl-2/Bax ***, As2O3treatment induced autophagy in liver cancer cells;this finding was supported by western blot, immunofluorescence of LC3-II and beclin 1, and transmission electron microscopy. In liver cancer cells, As2O3inhibited the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR) signal pathway that plays a vital role in both apoptosis and autophagy. The PI3K activator SC-79 partially reversed As2O3-induced autophagy and apoptosis. Furthermore, inhibiting autophagy with 3-methyladenine partially reversed the negative effects of As2O3on cell *** starvation increased autophagy and amplified the effect of As2O3on cell ***: As2O3induces apoptosis and autophagy in liver cancer cells. Autophagy induced by As2O3may have a proapoptotic effect that helps to reduce the viability of liver cancer cells. This study provides novel insights

关键词： Apoptosis Arsenic trioxide Autophagy Primary liver cancer

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Brazilin Actuates Ferroptosis in Breast Cancer Cells via p53/SLC7A11/GPX4 Signaling Pathway

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chinese Journal of Integrative medicine 2024年第11期30卷 1001-1006页

作者： HE Dan TAN Xiao-ning LI Lin-pei GAO Wen-hui TIAN Xue-fei ZENG Pu-hua Hunan Academy of chinese medicine School of Integrated chinese and western medicine Hunan University of Chinese Medicine Scientific Research department The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine oncology department The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine School of traditional chinese medicine Hunan University of Chinese Medicine

Objective:To investigate the mechanism of induction of ferroptosis by brazilin in breast cancer ***:Breast cancer 4T1 cells were divided into 6 groups:control,brazilin 1/2 half maximal inhibitory concentration(IC50),IC50,2×IC50,erastin（10 μg/mL） and capecitabine（10 μg/mL） *** effect of brazilin on the proliferation of 4T1 cells was detected by cell counting kit-8 assay,and the treatment dose of brazilin was *** effect of brazilin on the mitochondrial morphology of 4T1 cells,and the mitochondrial damage was evaluated under electron *** levels of Fe2+,reactive oxygen species（ROS）,malondialdehyde（MDA）,glutathione（GSH） and glutathione peroxidase 4（GPX4） were estimated using various detection *** invasion and migration abilities of 4T1 cells were detected by scratch assay and transwell *** expressions levels of tumor protein p53, solute carrier family 7 member 11（SLC7A11）,GPX4 and acyl-CoA synthetase long-chain family member 4（ACSL4） proteins were quantified by western blot ***:Compared to the control group,the 10(1/2 IC50),20(IC50) and 40(2×IC50) μg/mL brazilin,erastin,and capecitabine groups showed a significant decrease in the cell survival rate,invasion and migration abilities,GSH,SLC7A11 and GPX4 protein expression levels,and mitochondrial volume and ridge（P<0.05）,and a significant increase in the mitochondria membrane density,Fe2+,ROS and MDA levels,and p53 and ACSL4protein expression levels（P<0.05）.Conclusions:Brazilin actuated ferroptosis in breast cancer cells,and the underlying mechanism is mainly associated with the p53/SLC7A11/GPX4 signaling pathway.

关键词： chinese medicine brazilin breast cancer ferroptosis p53/SLC7A11/GPX4 axis

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Scorpiones,Scolopendra and Gekko Inhibit Lung Cancer Growth and Metastasis by Ameliorating Hypoxic Tumor Microenvironment via PI3K/AKT/mTOR/HIF-1αSignaling Pathway

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chinese Journal of Integrative medicine 2024年第9期30卷 799-808页

作者： MAO Qi-yuan WANG Xue-qian LIN Fei YU Ming-wei FAN Hui-ting ZHENG Qi LIU Lan-chun ZHANG Chu-chu LI Dao-rui LIN Hong-sheng department of oncology Guang’anmen HospitalChina Academy of Chinese Medical SciencesBeijing100053China department of oncology Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing100010China department of Cardiology Guang’anmen HospitalChina Academy of Chinese Medical SciencesBeijing100053China Institute of traditional chinese medicine Information China Academy of Chinese Medical SciencesBeijing100700China

Objective:To investigate whether Buthus martensii karsch(Scorpiones),Scolopendra subspinipes mutilans ***(Scolopendra)and Gekko gecko Linnaeus(Gekko)could ameliorate the hypoxic tumor microenvironment and inhibit lung cancer growth and metastasis by regulating phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin/hypoxia-inducible factor-1α(PI3K/AKT/mTOR/HIF-1α)signaling ***:Male C57BL/6J mice were inoculated with luciferase labeled LL/2-luc-M38 cell suspension to develop lung cancer models,with rapamycin and cyclophosphamide as positive *** methyl cellulose solutions of Scorpiones,Scolopendra and Gekko were administered intragastrically as 0.33,0.33,and 0.83 g/kg,respectively once daily for 21 *** expression were detected every 7 days after inoculation,and tumor growth curves were *** was performed to determine CD31 and HIF-1αexpressions in tumor tissue and microvessel density(MVD)was *** blot was performed to detect the expression of PI3K/AKT/mTOR/HIF-1αsignaling pathway-related ***-linked immunosorbent assay was performed to detect serum basic fibroblast growth factor(bFGF),transforming growth factor-β1(TGF-β1)and vascular endothelial growth factor(VEGF)in ***:Scorpiones,Scolopendra and Gekko prolonged the survival time and inhibited lung cancer metastasis and expression of HIF-1α(all P<0.01).Moreover,Scorpiones,Scolopendra and Gekko inhibited the phosphorylation of AKT and ribosomal protein S6 kinase(p70S6K)(P<0.05 or P<0.01).In addition,they also decreased the expression of CD31,MVD,bFGF,TGF-β1 and VEGF compared with the model group(P<0.05 or P<0.01).Conclusion:Scorpiones,Scolopendra and Gekko all showed beneficial effects on lung cancer by ameliorating the hypoxic tumor microenvironment via PI3K/AKT/mTOR/HIF-1αsignaling pathway.

关键词： Scorpiones Scolopendra Gekko dredging collaterals and activating blood chinese medicine of worms lung cancer hypoxic tumor microenvironment phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin/hypoxia-inducible factor-1α signaling pathway

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Patient-Reported Outcomes of Postoperative NSCLC Patients with or without Staged chinese Herb medicine Therapy during Adjuvant Chemotherapy(NALLC 2): A Randomized, Double-Blind, Placebo-Controlled Trial

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chinese Journal of Integrative medicine 2024年第11期30卷 963-973页

作者： ZHANG Yi-lu JIAO Li-jing GONG Ya-bin XU Jian-fang NI Jian SHEN Xiao-yong ZHANG Jie ZHOU Di QIAN Cheng-xin WANG Qin YAO Jia-lin YANG Wen-xiao SU Ling-zi WANG Li-yu LI Jia-qi YAO Yi-qin ZHANG Yuan-hui WANG Yi-chao CHEN Zhi-wei XU Ling oncology department Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Shanghai University of Traditional Chinese Medicine Institute of traditional chinese medicine oncology Shanghai University of Traditional Chinese Medicine oncology department Shanghai Pulmonary Hospital Shanghai Tongji University Thoracic Surgery department Huadong Hospital Shanghai Fudan University Thoracic Surgery department Shanghai Cancer Hospital Shanghai Fudan University oncology department Shanghai Chest Hospital Shanghai Jiao Tong University

Objective:To investigate whether the combination of chemotherapy with staged chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prolong the time before deterioration of lung cancer symptoms,in comparison to chemotherapy ***:A prospective,double-blind,randomized,controlled trial was conducted from December 14,2017 to August 28,2020.A total of 180 patients with stage ⅠB-ⅢA NSCLC from 5 hospitals in Shanghai were randomly divided into chemotherapy combined with CHM(chemo+CHM) group(120 cases) or chemotherapy combined with placebo(chemo+placebo) group(60 cases) using stratified blocking *** European Organization for Research and Treatment of Cancer(EORTC) Quality-of-Life-Core 30 Scale(QLQ-C30) was used to evaluate the patient-reported outcomes(PROs) during postoperative adjuvant chemotherapy in patients with early-stage *** events(AEs) were assessed in the safety ***:Out of the total 180 patients,173 patients(116in the chemo+CHM group and 57 in the chemo+placebo group) were included in the PRO *** initial mean QLQ-C30 Global Health Status(GHS)/QoL scores at baseline were 57.16±1.64 and 57.67±2.25 for the two respective groups(P>0.05).Compared with baseline,the chemo+CHM group had an improvement in QLQ-C30GHS/QoL score at week 18 [least squares mean(LSM) change 17.83,95% confidence interval(CI) 14.29 to 21.38].Conversely,the chemo+placebo group had a decrease in the score(LSM change-13.67,95% CI-22.70 to-4.63).A significant between-group difference in the LSM GHS/QoL score was observed,amounting to 31.63 points(95% CI25.61 to 37.64,P<0.001).The similar trends were observed in physical functioning,fatigue and appetite *** week 18,patients in the chemo+CHM group had a higher proportion of improvement or stabilization in GHS/QoL functional and symptom scores compared to chemo+placebo group(P<0.001).The median time to deterioration

关键词： chinese herbal medicine adjuvant chemotherapy health-related quality of life non-small-cell lung cancer patient-reported outcome

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chinese medicine Prolongs Overall Survival of chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study

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chinese Journal of Integrative medicine 2024年第6期30卷 489-498页

作者： CAO Ni-da ZHU Xiao-hong MA Fang-qi XU Yan DONG Jia-huan QIN Meng-meng LIU Tian-shu ZHU Chun-chao GUO Wei-jian DING Hong-hua GUO Yuan-biao LIU Li-kun SONG Jin-jie WU Ji-ping CHENG Yue-lei ZENG Lin ZHAO Ai-guang oncology department I Longhua Hospital Shanghai University of Traditional Chinese MedicineShanghai200032China oncology department Zhongshan HospitalFudan UniversityShanghai200032China Gastrointestinal Surgery department Renji HospitalShanghai Jiaotong University School of MedicineShanghai200127China oncology department Fudan University Shanghai Cancer CenterShanghai200032China oncology department Shanghai General HospitalShanghai Jiaotong University School of MedicineShanghai200080China traditional chinese medicine department Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai200025China oncology department Shanxi Traditional Chinese Medicine HospitalTaiyuan030012China oncology department Xiyuan HospitalChina Academy of Chinese Medical ScienceBeijing102445China oncology department Yunnan Province Hospital of Traditional Chinese MedicineKunming650021China oncology department Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghai201203China Shanghai NewCore Biotechnology Co. Ltd.Shanghai200240China

Objective To describe the treatment patterns and survival status of advanced gastric cancer(AGC)in China in the past two decades,and objectively evaluate the impact of standardized chinese medicine(CM)treatment on the survival of AGC *** This multicenter registry designed and propensity score analysis study described the diagnosis characteristics,treatment-pattern development and survival status of AGC from 10 hospitals in China between January 1,2000 and July 31,*** survival(OS)was evaluated between non-CM cohort(standard medical treatment)and CM cohort(integrated standard CM treatment≥3 months).Propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)were performed to adjust any difference in average outcomes for *** A total of 2,001 patients histologically confirmed locally advanced and/or metastasis stomach and gastroesophageal junction adenocarcinoma were *** them,1,607 received systemic chemotherapy,215(10.74%)accepted molecular targeted therapy,44(2.2%)received checkpoint inhibitor therapy,and 769(38.43%)received ***-drug regimen was the main choice for first-line treatment,with fluoropyrimidine plus platinum as the most common regimen(530 cases,60.09%).While 45.71%(16 cases)of patients with HER2 amplification received trastuzumab in *** application of apatinib increased(33.33%)in *** application of checkpoint inhibitors has increased since *** analysis showed that Lauren mixed type(P=0.017),cycles of first-line treatment>6(P=0.000),CM(P=0.000),palliative gastrectomy(P=0.000),trastuzumab(P=0.011),and apatinib(P=0.008)were independent prognostic factors for the OS of *** PSM and IPTW,the median OS of CM cohort and non-CM cohort was 18.17 and 12.45 months,respectively(P<0.001).Conclusions In real-world practice for AGC in China,therapy choices consisted with ***-drug regimen was the main first-line *** CM treatment was an independent

关键词： advancedgastriccancer real-world study treatment pattern survival analysis chinese medicine

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Cycloastragenol induces apoptosis and protective autophagy through AMPK/ULK1/mTOR axis in human non-small cell lung cancer cell lines

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Journal of Integrative medicine 2024年第4期22卷 503-514页

作者： Li-hua Zhu Yu-pei Liang Lian Yang Feng Zhu Li-jun Jia He-gen Li department of oncology Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China Cancer Institute of traditional chinese medicine Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China department of Laboratory medicine Huadong HospitalFudan UniversityShanghai 200237China

Objective:Studies have demonstrated that cycloastragenol induces antitumor effects in prostate,colorectal and gastric cancers;however,its efficacy for inhibiting the proliferation of lung cancer cells is largely *** study explores the efficacy of cycloastragenol for inhibiting non-small cell lung cancer(NSCLC)and elucidates the underlying molecular ***:The effects of cycloastragenol on lung cancer cell proliferation were assessed using an adenosine triphosphate monitoring system based on firefly luciferase and clonogenic formation ***-induced apoptosis in lung cancer cells was evaluated using dual staining flow cytometry with an annexin V-fluorescein isothiocyanate/propidium iodide *** elucidate the role of cycloastragenol in the induction of apoptosis,apoptosis-related proteins were examined using western *** and western blotting were used to determine whether cycloastragenol could induce autophagy in lung cancer *** techniques,including small interfering RNA technology,were used to investigate the underlying *** effects against lung cancer and biosafety of cycloastragenol were evaluated using a mouse subcutaneous tumor ***:Cycloastragenol triggered both autophagy and ***,cycloastragenol promoted apoptosis by facilitating the accumulation of phorbol-12-myristate-13-acetate-induced protein 1(NOXA),a critical apoptosis-related ***,cycloastragenol induced a protective autophagy response through modulation of the adenosine 5'-monophosphate-activated protein kinase(AMPK)/unc-51-like autophagy-activating kinase(ULK1)/mammalian target of rapamycin(mTOR)***:Our study sheds new light on the antitumor efficacy and mechanism of action of cycloastragenol in *** insight provides a scientific basis for exploring combination therapies that use cycloastragenol and inhibiting the AMPK/ULK1/mTOR pathway as a promising approach to

关键词： Non-small cell lung cancer Cycloastragenol Autophagy Apoptosis

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Palmitic acid reduces the methylation of the FOXO1 promoter to suppress the development of diffuse large B-cell lymphoma via modulating the miR-429/DNMT3A axis

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chinese Journal of Natural medicines 2024年第6期22卷 554-567页

作者： LI Weiming GAO Ming XUE Weili LI Xiaoli CHANG Yu ZHANG Kaixin WEN Chenyu ZHANG Mingzhi department of oncology Henan University of Traditional Chinese MedicineZhengzhou 450000China department of oncology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000China

Diffuse large B-cell lymphoma(DLBCL)is characterized by significant treatment *** acid(PA)has shown promising antitumor *** study aims to elucidate the molecular mechanisms by which PA influences DLBCL *** quantified the expression levels of microRNAs(miRNAs),Forkhead box protein O1(FOXO1),and DNA methyltransferase 3A(DNMT3A)in both untreated and PA-treated DLBCL tumors and cell *** were made of cell viability,apoptosis,and autophagy-related protein expression following PA *** analyses among miR-429,DNMT3A,and FOXO1 were conducted using luciferase reporter assays and methylation-specific(MSP)Polymerase chain reaction(PCR).After transfecting the miR-429 inhibitor,negative control(NC)inhibitor,shRNA against DNMT3A(sh-DNMT3A),shRNA negative control(sh-NC),over-expression vector for DNMT3A(oe-DNMT3A),or overexpression negative control(oe-NC),we evaluated the effects of miR-429 and DNMT3A on cell viability,mortality,and autophagy-related protein expression in PA-treated DLBCL cell *** efficacy of PA was also tested in vivo using DLBCL tumor-bearing mouse ***-429 and FOXO1 expression levels were downregulated,whereas DNMT3A was upregulated in DLBCL compared to the control *** treatment was associated with enhanced autophagy,mediated by the upregulation of miR-429 and downregulation of *** luciferase reporter assay and MSP confirmed that miR-429 directly inhibits DNMT3A,thereby reducing FOXO1 *** experiments demonstrated that PA promotes autophagy and inhibits DLBCL progression by upregulating miR-429 and modulating the DNMT3A/FOXO1 *** vivo PA signific-antly reduced the growth of xenografted tumors through its regulatory impact on the miR-429/DNMT3A/FOXO1 *** acid may modulate autophagy and inhibit DLBCL progression by targeting the miR-429/DNMT3A/FOXO1 signaling pathway,suggesting a novel therapeutic target for DLBCL management.

关键词： Palmitic acid Diffuse large B-cell lymphoma MiR-429 DNMT3A FOXO1 Autophagy

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Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

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chinese Journal of Integrative medicine 2024年第5期30卷 449-457页

作者： XIE Shuang-ran MA Liang XU Xin-yu ZHOU Shu XIE Hui-miao XIE Chang-sheng The First Clinical medical College Zhejiang Chinese Medical UniversityHangzhou 310053China department of medical oncology Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhou 310007China department of Dermatology the Third Xiangya HospitalCentral South UniversityChangsha 410013China department of Famous chinese medicine Clinic the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310005China department of medical oncology the First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006China

Backgroup:Currently,aromatherapy is being increasingly utilized in clinical practice,particularly in managing the side effects associated with radiotherapy and ***,it remains to be established whether aromatherapy can effectively alleviate these ***:To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and ***:Seven databases were researched from inception until September 29,2023,including PubMed,Scopus,and Web of Science,chinese National Knowledge Infrastructure,Wanfang database,China Biology medicine disc and VIP chinese medical Journal *** Manager version 5.3 was utilized for data *** Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the *** quality rating was assessed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE) approach through the GRADEpro GDT online ***:Nineteen studies involving 1,541 patients were *** can alleviate nausea [relative risk(RR)=0.64,95% confidence interval(CI):0.53 to 0.78,P<0.05,I^(2)=46%;standardized mean difference(SMD)=-0.86,95% CI:-1.21 to-0.51,P<0.05,I^(2)=64%] and vomiting(RR=0.54,95% CI:0.42 to 0.69,P<0.05,I^(2)=35%;SMD=-1.28,95% CI:-1.52 to-1.03,P<0.05,I^(2)=92%),improve sleep disorders [mean difference(MD)=-3.39,95% CI:-3.95 to-2.84,P<0.05,I^(2)=0%],relieve pain(SMD=-1.58,95% CI:-1.96 to-1.21,P<0.05,I^(2)=0%),mitigate fatigue(SMD=-1.28,95% CI:-2.44 to-0.11,P<0.05,I^(2)=93%) and enhance quality of life(SMD=0.50,95% CI:0.22 to 0.79,P<0.05,I^(2)=0%) in cancer patients after radiotherapy and chemotherapy,but it may not have a significant effect on *** risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2,and no studies were considered to be of high grade according to the GRADE ***:Aromatherapy is an efficacious,safe a

关键词： aromatherapy cancer chemoradiotherapy physical psychological

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Multifaceted role of microRNAs in gastric cancer stem cells: Mechanisms and potential biomarkers

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World Journal of Gastrointestinal oncology 2024年第2期16卷 300-313页

作者： Qian-Hui Sun Zi-Yu Kuang Guang-Hui Zhu Bao-Yi Ni Jie Li department of oncology Guang'anmen HospitalChina Academy of Chinese Medical SciencesBeijing 100053China Graduate College Beijing University of Traditional Chinese MedicineBeijing 100029China department of oncology Heilongjiang University of Chinese MedicineHarbin 150040Heilongjiang ProvinceChina

MicroRNAs(miRNAs)have received much attention in the past decade as potential key epigenomic regulators of tumors and cancer stem cells(CSCs).The abnormal expression of miRNAs is responsible for different phenotypes of gastric cancer stem cells(GCSCs).Some specific miRNAs could be used as promising biomarkers and therapeutic targets for the identification of *** review summarizes the coding process and biological functions of miRNAs and demon-strates their role and efficacy in gastric cancer(GC)metastasis,drug resistance,and apoptosis,especially in the regulatory mechanism of *** shows that the overexpression of onco-miRNAs and silencing of tumor-suppressor miRNAs can play a role in promoting or inhibiting tumor metastasis,apart from the initial formation of *** also discusses the epigenetic regulation and potential clinical applications of miRNAs as well as the role of CSCs in the pathogenesis of *** believe that this review may help in designing novel therapeutic approaches for GC.

关键词： Gastric cancer,Cancer stem cells MicroRNAs Epigenetics Therapeutic target

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Efficacy and Safety of chinese Herbal medicines combined with Chemical Drugs for Alzheimer's Disease:A Systematic Review and Meta-Analysis

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World Journal of traditional chinese medicine 2024年第1期10卷 1-13页

作者： Li Xu Wen-Jun Chen Cai-Jun Tian Yan Zhang Yan Ma Tian-Hao Li Hong-Jie Liu Zhe Zhang department of the First College English College of Foreign LanguageShandong University of Traditional Chinese MedicineJinanChina department of oncology Linyi People's HospitalLinyiChina department of Internal medicine of traditional chinese medicine The First Clinical CollegeShandong University of Traditional Chinese MedicineJinanChina department of chinese Materia Medica College of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineJinanChina department of Medicinal Chemistry College of PharmacyShandong University of Traditional Chinese MedicineJinanChina Community Healthcare Center Shenzhen Traditional Chinese Medicine HospitalShenzhenChina department of Fundamentals of traditional chinese medicine School of Traditional Chinese MedicineJinan UniversityGuangzhouChina Shandong Co-Innovation Center of Classic TCM Formula College of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineJinanChina

Objective:To evaluate the efficacy and safety of chinese herbal medicines(CHMs)combined with chemical drugs for the treatment of Alzheimer's disease(AD).Materials and Methods:Databases were searched to retrieve randomized controlled trials(RCTs)of CHMs combined with tacrine,galantamine,rivastigmine,donepezil,or memantine,following strict inclusion and exclusion *** research papers published in English,chinese,and Japanese were *** primary outcome was the mini-mental state examination(MMSE)score and the secondary outcomes were AD assessment scale cognitive subscale(ADAS-Cog)score and safety ***-analysis was carried out using Rev Man 5.3 and subgroup analysis was conducted to identify the sources of ***:A total of 15 RCTs with 1386 participants were included in this *** donepezil was used in the retrieved ***-analyses showed that the combination of CHMs with donepezil led to significant improvement in the MMSE score(Z=9.45;P<0.00001;weighted mean difference[WMD]=2.68,95%confidence interval[CI]:2.12-3.24)and a significant decrease in the ADAS-Cog score(Z=5.53;P<0.00001;WMD=-3.79;95%CI:-5.13--2.44).Safety evaluation demonstrated that these combination treatments relieved adverse events such as insomnia(risk ratio[RR]=0.20,95%CI:0.06-0.68;P=0.01)and hive(RR=0.10;95%CI:0.01-0.73;P=0.02).Conclusions:The combination of CHMs with a chemical drug like donepezil led to significant improvements in patient cognition as well as a better safety profile when compared to the application of a chemical drug alone.

关键词： Alzheimer's disease chinese herbal medicine donepezil memantine meta-analysis randomized controlled trials rivastigmine

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