Efficacy of Combined Herbal and Western Medicine Based on Traditional Chinese Medicine for Mild Cognitive Impairment and Dementia in Parkinson’s Disease: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
INTRODUCTION: This systematic review aimed to assess the clinical evidence supporting the combination of syndrome differentiation (SD)-based herbal medicine (HM) and Western medicine (WM) in treating Parkinson's disease (PD)-mild cognitive impairment (PD-MCI) and -dementia (PDD). METHODS: Ten electronic bibliographic databases were searched from inception to March 4, 2024, for randomized controlled trials (RCTs) comparing SD-based HM plus conventional therapies with conventional therapies alone for PD-MCI and PDD. Two authors independently screened and selected studies and extracted data related to trial quality, characteristics, and results. The mean difference (MD) was used to analyze continuous variables, and meta-analysis was performed using Reviewer Manager 5.4 software. The risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS: For the 15 articles selected for review, 12 trials were included in the meta-analysis: 9 comprising 688 patients with PD-MCI and 3 comprising 264 patients with PDD and with a type of SD, such as "blood stasis and stirring wind" or "deficiency of the liver-kidney." The meta-analysis showed significant differences favoring HM plus WM with respect to the Montreal Cognitive Assessment score for PD-MCI (MD = 2.30, 95% confidence interval [CI; 1.40, 3.19]; p < 0.00001, I2 = 76%) and PDD (MD = 3.14, 95% CI [0.48, 5.81]; p = 0.02, I2 = 82%) compared with WM alone. Improvement of cognitive impairment treated using "deficiency of the liver-kidney" SD-based HM plus WM in PD-MCI was more beneficial than that treated using WM alone. CONCLUSIONS: SD-based HM may serve as an adjunctive treatment for PD-MCI and PDD, improving cognitive function and alleviating PD symptoms. No severe adverse event was observed in the HM plus WM group, suggesting that HM may be safe for patients with cognitive impairment in PD. However, evidence regarding the efficacy of HM based on SD for PD-MCI and PDD is of poor quality, and all studies were conducted in China. Thus, and rigorous, multicenter, and international RCTs are required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.026 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.020 | 0.032 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".