【摘要】 目的 采用网状meta分析评价基于药物和非药物疗法的多种干预措施治疗轻中度阿尔茨海默病（AD）的有效性和安全性。方法 检索Pub Med、Embase、Cochrane图书馆、CBM、维普网、CNKI和万方数据库建库至2021年9月发表的有关药物和非药物措施治疗轻中度AD的随机对照试验。采用Rev Man 5.3软件对纳入的文献进行质量评价，采用Stata 15.0软件进行网状meta分析。结果 共纳入62项研究，包括10 934例患者。网状meta分析结果显示，在改善简易精神状态检查（MMSE）评分方面，各干预措施的累计排序概率曲线下面积（SUCRA）由大到小排序为针灸（92.4%）>经颅直流电刺激（85.5%）>认知疗法（70.7%）>美金刚（60.6%）>石杉碱甲（56.0%）>卡巴拉汀（50.9%）>多奈哌齐（41.4%）>银杏叶提取物（26.7%）>安慰剂（13.3%）>加兰他敏（2.4%）。在安全性方面，各干预措施的SUCRA由大到小排序为银杏叶提取物（85.0%）>针灸（74.7%）>安慰剂（67.4%）>美金刚（65.0%）>石杉碱甲（49.3%）>多奈哌齐（27.5%）>加兰他敏（21.8%）>卡巴拉汀（9.4%）。MMSE评分和不良反应总发生率的漏斗图分布相对对称，提示不存在显著的发表偏倚。结论 本研究分析了多种干预措施治疗轻中度AD的效果，可帮助临床医师和政策制订者做出更好的决策。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of multiple interventions based on drug and non-drug therapy in the treatment of mild to moderate Alzheimer’s disease(AD) by mesh meta-analysis. Methods Pub Med, Embase, Cochrane Library, CBM, VIP, CNKI, and Wanfang Data were searched for randomized controlled trials on drug and non-drug measures for the treatment of mild to moderate AD published from the inception to September 2021. Rev Man 5.3 software was used to evaluate the quality of the included literatures, and Stata 15.0 software was used for network meta-analysis.Results A total of 62 literatures including 10 934 patients were included. The results of mesh meta-analysis showed that in terms of improving the mini-mental state examination(MMSE) score, the surface under the cumulative ranking(SUCRA) of each intervention in descending order was acupuncture(92.4%) > transcranial direct current stimulation(85.5%) >cognitive therapy(70.7%) > Mementin(60.6%) > Huperzine A(56.0%) > Carbalatine(50.9%) > Donepezil(41.4%) >Ginkgo biloba extraction(26.7%) > placebo(13.3%) > Galantamine(2.4%). In terms of safety, the SUCRA of each intervention in descending order was Ginkgo biloba extraction(85.0%) > acupuncture(74.7%) > placebo(67.4%) >Mementin(65.0%) > Huperzine A(49.3%) > Donepezil(27.5%) > Galantamine(21.8%) > Carbalatine(9.4%). The funnel plots of MMSE score and the total incidence of adverse events were relatively symmetric, suggesting that there was no significant publication bias. Conclusion This study analyzed the effectiveness of multiple interventions in the treatment of mild to moderate AD, which can help clinicians and policy makers make better decisions.更多还原