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E-raamat: Evidence-based Clinical Chinese Medicine - Volume 9: Vascular Dementia

(Rmit Univ, Australia), Editor-in-chief (Guangdong Provincial Hospital Of Chinese Medicine, China), (Guangdong Provincial Hospital Of Chinese Medicine, China), Editor-in-chief (Rmit Univ, Australia)
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"The ninth volume of Evidence-based Clinical Chinese Medicine aims to provide a multi-faceted ""whole evidence"" analysis of the management of Vascular Dementia in Chinese and integrative medicine. Beginning with overviews of how Vascular Dementia is conceptualized and managed in both conventional medicine and contemporary Chinese medicine, the authors then provide detailed analyses of how dementia and memory disorders were treated with herbal medicine and acupuncture in past eras. The subsequent chapters comprehensively review the current state of the clinical trial evidence for Chinese herbal medicines, acupuncture and other Chinese medicine therapies in the management of Vascular Dementia, as well as analyse and evaluate the results of these studies from an evidence-based medicine perspective. The outcomes of these analyses are summarised and discussed in terms of their implications for the clinical practice of Chinese medicine and for future research. The authors are internationally recognized, well-respected leaders in the field of Chinese medicine and evidence-based medicine with strong track records in research. This book can inform clinicians and students in the fields of integrative and Chinese medicine of the current state of the evidence for a range of Chinese medicine therapies in Vascular Dementia, including the use of particular herbal formulas and acupuncture treatments in order to assist clinicians in making evidence-based decisions in patient care. This book provides: A focus on Vascular Dementia complementing Vol 8 on Alzheimer's disease. Detailed information on traditional and classical treatment methods. Comprehensive assessments of the evidence, based on rigorous methods. By providing all this information in one handy, easy to use reference, this book allows practitioners to focus on providing high quality health care, with the knowledge it is based on the best available evidence."

Disclaimer v
Foreword vii
Purpose of the Monograph xi
Authors and Contributors xv
Member of Advisory Committee and Panel xvii
Distinguished Professor Charlie Changli Xue, PhD xix
Professor Chuanjian Lu, MD xxi
Acknowledgements xxiii
List of Figures xxxix
List of Tables xli
1 Introduction to Vascular Dementia 1(26)
Definition of Vascular Dementia
1(1)
Clinical Presentation
2(1)
Epidemiology of Dementia and Vascular Dementia
3(1)
Burden of Dementia and Vascular Dementia
4(1)
Risk Factors
4(2)
Pathological Processes
6(1)
Diagnosis
7(4)
DSM-5 Criteria
9(2)
Subtypes
11(1)
Assessment
11(1)
Differential Diagnosis
12(2)
Management
14(6)
Pharmacological Interventions for Vascular Dementia
15(4)
Non-pharmacological Interventions for Vascular Dementia
19(1)
Limitations of Conventional Therapy
19(1)
Prognosis
20(1)
Prevention
20(1)
References
21(6)
2 Vascular Dementia in Chinese Medicine 27(14)
Introduction
27(1)
Aetiology and Pathogenesis
28(1)
Syndrome Differentiation
29(7)
Herbal Medicine Treatment Based on Syndrome Differentiation
29(1)
Deficiency of 'Sea of Marrow' (sui hai bu zu)
29(1)
Spleen and Kidney Dual Deficiency (pi shen liang xu)
30(1)
Deficiency of Qi and Blood (qi xue kui xu)
31(1)
Turbid Phlegm Obstructing the Orifices (tan zhuo meng qiao)
32(1)
Blood Stasis Obstructing the Brain Collaterals (yu zu nao luo)
32(1)
Heart and Liver Fire (xing gan huo wang)
33(1)
Endogenous Toxins Damaging the Brain Collaterals (du sun nao luo)
34(1)
Empirical Formulae
35(1)
Suan zao ren shen bu nao tang
35(1)
Nv zhen zi jian
36(1)
Acupuncture and Related Therapies
36(1)
Other Management Strategies
36(2)
Prevention and Nursing in Chinese Medicine
38(1)
Nursing and Rehabilitation
38(1)
Diet Therapy
39(1)
Prognosis
39(1)
References
39(2)
3 Classical Chinese Medicine Literature 41(30)
Introduction
41(2)
Search Terms
43(2)
Procedures for Search, Data Coding, and Data Analysis
45(2)
Search Results
47(1)
Definitions of the Condition and Aetiology
47(2)
Chinese Herbal Medicine
49(12)
Frequency of Treatment Citations by Dynasty
49(1)
Treatment with Chinese Herbal Medicine
50(1)
Most Frequent Formulae in 'Possible' Vascular Dementia Citations
50(3)
Most Frequent Herbs in 'Possible' Vascular Dementia Citations
53(2)
Most Frequent Formulae in 'Likely' Vascular Dementia Citations
55(1)
Most Frequent Herbs in 'Likely' Vascular Dementia Citations
55(1)
Discussion of Chinese Herbal Medicine for Vascular Dementia
55(6)
Acupuncture and Related Therapies
61(4)
Frequency of Treatment Citations by Dynasty
61(1)
Frequency of Acupuncture Points
62(1)
Discussion of Acupuncture and Related Therapies
63(2)
The Classical Literature in Perspective
65(3)
References
68(3)
4 Methods for Evaluating Clinical Evidence 71(16)
Introduction
71(1)
Search Strategy
72(1)
Inclusion Criteria
73(4)
Study Type
73(1)
Participants
73(1)
Interventions
74(1)
Comparators in Controlled Trials (Randomised Controlled Trials and Controlled Clinical Trials)
75(1)
Settings
75(1)
Outcomes
75(2)
Exclusion Criteria
77(2)
Study Type
77(1)
Participants
77(1)
Interventions
78(1)
Comparators in Controlled Trials (Randomised Controlled Trials and Controlled Clinical Trial)
78(1)
Outcomes
78(1)
Risk of Bias
79(1)
Statistical Analyses
80(1)
Summary of Findings
81(2)
Assessment Using GRADE
81(2)
References
83(4)
5 Clinical Evidence for Chinese Herbal Medicine 87(78)
Previous Systematic Reviews
87(2)
Identification of Clinical Studies
89(1)
Chinese Herbal Medicine
89(12)
Randomised Controlled Trials of Oral Chinese Herbal Medicine
89(5)
Risk of Bias
94(1)
Results of Meta-analyses of Outcome Measures
95(1)
Mini-Mental State Examination
96(1)
Chinese Herbal Medicine vs. Inactive Controls
96(1)
Chinese Herbal Medicine vs. Pharmacotherapy
97(1)
Chinese Herbal Medicine vs. Donepezil
98(1)
Chinese Herbal Medicine vs. Huperzine A
98(1)
Chinese Herbal Medicine vs. Nimodipine
98(1)
Chinese Herbal Medicine vs. Flunarizine
99(1)
Chinese Herbal Medicine vs. Co-dergocrine Mesylate
100(1)
Chinese Herbal Medicine vs. Dihydroergotoxine Injection
100(1)
Chinese Herbal Medicine vs. Nicergoline
100(1)
Chinese Herbal Medicine vs. Piracetam
100(1)
Chinese Herbal Medicine vs. Oxiracetam
100(1)
Chinese Herbal Medicine vs. Aniracetam
101(1)
Sensitivity Analysis
101(1)
Integrative Chinese Herbal Medicine
101(3)
Chinese Herbal Medicine plus Donepezil vs. Donepezil
102(1)
Chinese Herbal Medicine plus Huperzine A vs. Huperzine A
103(1)
Chinese Herbal Medicine plus Nimodipine vs. Nimodipine
103(1)
Chinese Herbal Medicine plus Co-dergocrine Mesylate vs. Co-dergocrine Mesylate
103(1)
Chinese Herbal Medicine plus Aniracetam vs. Aniracetam
103(1)
Chinese Herbal Medicine plus Other Pharmacotherapies
104(1)
Sensitivity Analysis
104(1)
Summary for Mini-Mental State Examination
104(1)
Hasegawa's Dementia Scale
105(4)
Chinese Herbal Medicine vs. Placebo
105(1)
Chinese Herbal Medicine vs. Pharmacotherapy
105(1)
Chinese Herbal Medicine vs. Huperzine A
106(1)
Chinese Herbal Medicine vs. Nimodipine
106(1)
Chinese Herbal Medicine vs. Co-dergocrine Mesylate
106(2)
Chinese Herbal Medicine vs. Nicergoline
108(1)
Chinese Herbal Medicine vs. Dihydroergotoxine
108(1)
Chinese Herbal Medicine vs. Aniracetam
108(1)
Chinese Herbal Medicine vs. Piracetam
108(1)
Chinese Herbal Medicine vs. Oxiracetam
108(1)
Sensitivity Analysis
109(1)
Integrative Chinese Herbal Medicine
109(1)
Sensitivity Analysis
109(1)
Summary for Hasegawa's Dementia Scale
110(1)
Alzheimer's Disease Assessment Scale - Cognitive Subscale
111(1)
Summary for Alzheimer's Disease Assessment Scale - Cognitive Subscale
111(1)
Activities of Daily Living
112(7)
Chinese Herbal Medicine vs. Placebo
113(1)
Chinese Herbal Medicine vs. Pharmacotherapy
113(1)
Studies Using 'Lower is Better' Activities of Daily Living Scales
114(1)
Studies Using 'Higher is Better' Activities of Daily Living Scales
114(2)
Integrative Chinese Herbal Medicine
116(1)
Studies Using 'Lower is Better' Activities of Daily Living Scales
117(1)
Studies Using 'Higher is Better' Activities of Daily Living Scales
118(1)
Sensitivity Analysis
119(1)
Summary for Activities of Daily Living Scales
120(1)
Functional Activities Questionnaire
120(2)
Summary for Functional Activities Questionnaire
122(1)
Blessed Behavior Scale
122(2)
Chinese Herbal Medicine vs. Placebo
123(1)
Chinese Herbal Medicine vs. Pharmacotherapy
123(1)
Integrative Chinese Herbal Medicine
124(1)
Summary for the Blessed Behaviour Scale
124(1)
Other Outcome Measures Reported in Randomised Controlled Trials
125(2)
Clock Drawing Test
125(1)
Wechsler Memory Scale
125(1)
Wechsler Adult Intelligence Scale
126(1)
Neuropsychiatric Inventory
126(1)
Clinical Dementia Rating
127(1)
GRADE for Main Chinese Herbal Medicine Comparisons
127(2)
Oral Chinese Herbal Medicine vs. Placebo
127(1)
Oral Chinese Herbal Medicine vs. Donepezil
127(1)
Integrative Medicine: Oral Chinese Herbal Medicine Combined with Donepezil vs. Donepezil Alone
128(1)
Randomised Controlled Trial Evidence for Individual Oral Chinese Herbal Medicine Formulae
129(2)
GRADE for Individual Formulae
131(12)
Modified Bu yang huan wu tang vs. Pharmacotherapy
133(1)
Modified Bu yang huan wu tang Combined with Pharmacotherapy vs. Pharmacotherapy
133(1)
Bu chang nao xin tong jiao nang vs. Pharmacotherapy
134(1)
Bu chang nao xin tong jiao nang Combined with Pharmacotherapy vs. Pharmacotherapy
134(1)
Frequently Reported Herbs in Meta-analyses Showing Favourable Effects
135(1)
Chinese Herbal Medicine vs. Specific Pharmacotherapy for Cognitive Outcome Measures
136(1)
Integrative Chinese Herbal Medicine vs. the Same Pharmacotherapy for Cognitive Outcome Measures
137(1)
Controlled Clinical Trials of Oral Chinese Herbal Medicine
138(2)
Mini-Mental State Examination
140(1)
Hasegawa's Dementia Scale
140(1)
'Lower is Better' Activities of Daily Living
141(1)
Non-controlled Studies of Oral Chinese Herbal Medicine
141(2)
Safety of Chinese Herbal Medicine for Vascular Dementia
143(1)
Clinical Evidence for Commonly Used Oral Formulae
143(2)
Summary of the Clinical Evidence for Oral Chinese Herbal Medicine
145(4)
References
149(16)
6 Pharmacological Actions of the Common Herbs 165(48)
Introduction
165(2)
Abbreviations Used in this
Chapter
166(1)
Experimental Studies on shi chang pu
167(4)
Extracts
167(1)
Asarones
167(1)
β-asarone
168(1)
α-asarone
168(2)
Eudesmin
170(1)
Experimental Studies on chuan xiong
171(3)
Tetramethylpyrazine
171(1)
L-3-n-butyl-phthalide
172(1)
Butylidenephthalide
173(1)
Other compounds
173(1)
Experimental Studies on dang gui
174(2)
Ferulic acid
174(1)
Ligustilide
175(1)
Senkyunolide I
175(1)
Experimental Studies on he shou wu
176(4)
Extracts
176(1)
2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside
177(2)
Resveratrol
179(1)
Other compounds
179(1)
Experimental Studies on huang qi
180(1)
Astragalosides
180(1)
Extracts and other compounds
181(1)
Experimental studies on dan Shen
181(5)
Danshensu
182(1)
Salvianolic Acids
182(1)
Rosmarinic Acid
183(1)
Protocatechuic Aldehyde
184(1)
Cryptotanshinone
185(1)
Tanshinones I and IIA
185(1)
Experimental Studies on yuan zhi
186(2)
Extracts and Fractions
186(1)
Tenuigenin
187(1)
Tenuifolin
187(1)
Experimental Studies on shui zhi
188(1)
Hirudin
188(1)
Tongxinluo
189(1)
Experimental Studies on di huang
189(3)
Catalpol
189(2)
Other Compounds
191(1)
Experimental Studies on you qi zi
192(1)
Extracts and Fractions
192(1)
Summary of Evidence From in Vivo and in Vitro Studies
193(1)
References
194(19)
7 Clinical Evidence for Acupuncture and Related Therapies 213(50)
Introduction
213(1)
Previous Systematic Reviews
214(1)
Identification of Clinical Studies
215(1)
Risk of Bias
215(2)
Studies of Acupuncture
217(23)
Randomised Controlled Trials of Acupuncture
217(1)
Syndromes
218(1)
Frequently Used Points in Randomised Controlled Trials of Acupuncture
219(1)
Acupuncture vs. Sham Acupuncture
220(1)
Acupuncture vs. No Treatment
220(1)
Acupuncture vs. Pharmacotherapy
220(9)
Integrative Acupuncture vs. Pharmacotherapy
229(6)
Frequently Reported Acupuncture Points in Meta-analyses
235(1)
Assessment of Acupuncture Using GRADE
236(1)
Acupuncture vs. Donepezil
237(3)
Clinical Evidence from Non-randomised Controlled Trials of Acupuncture
240(1)
Clinical Evidence from Non-controlled Studies of Acupuncture/Moxibustion
240(3)
Safety of Acupuncture and Electro-acupuncture
243(1)
Studies of Scalp Acupuncture
243(5)
Scalp Acupuncture vs. No Treatment
244(1)
Scalp Acupuncture vs. Pharmacotherapy
244(1)
Mini-Mental State Examination
245(1)
Hasegawa Dementia Scale
245(1)
Activities of Daily Living
246(1)
Memory Quotient
246(1)
Integrative Scalp Acupuncture
247(1)
Non-controlled Studies of Scalp Acupuncture
247(1)
Safety of Scalp Acupuncture
248(1)
Frequently Reported Scalp Acupuncture Zones in Meta-analyses
248(1)
Moxibustion
248(2)
Ear Acupuncture and Ear Acupressure
250(1)
Clinical Evidence for Commonly Used Acupuncture Interventions
250(2)
Summary of Clinical Evidence for Acupuncture and Related Therapies
252(4)
References
256(7)
8 Clinical Evidence for Other Chinese Medicine Therapies 263(12)
Introduction
263(5)
Previous Systematic Reviews
264(1)
Summary of the Clinical Evidence
264(2)
Chinese Exercise Therapy
266(1)
Randomised Controlled Trials
266(1)
Risk of Bias
267(1)
Results
267(1)
Mini-Mental State Examination
267(1)
Activities of Daily Living
267(1)
Non-controlled Studies
268(1)
Results
268(1)
Safety of Chinese Exercise Therapy
268(1)
Chinese Remedial Massage Therapy
268(2)
Results
270(1)
Safety of Chinese Remedial Massage Therapy
270(1)
Clinical Evidence for Other Chinese Medicine Therapies
270(1)
Summary of the Evidence for Other Chinese Medicine Therapies
270(2)
References
272(3)
9 Clinical Evidence for Combination Therapies 275(22)
Introduction
275(1)
Randomised Controlled Trials of Combination Therapies
275(18)
Risk of Bias
277(1)
Oral Chinese Herbal Medicine plus Acupuncture Therapy
278(1)
Syndromes
279(1)
Frequently Used Herbs and Acupuncture Points
279(1)
Chinese Herbal Medicine plus Acupuncture vs. No Treatment
280(1)
Chinese Herbal Medicine plus Acupuncture vs. Pharmacotherapy
281(1)
Mini-Mental State Examination
281(1)
Alzheimer's Disease Assessment Scale - Cognitive Subscale
282(1)
Hasegawa Dementia Scale
283(1)
Activities of Daily Living
284(1)
Blessed Dementia Scale
285(1)
Blessed Behaviour Scale
286(1)
Integrative Medicine: Chinese Herbal Medicine plus Acupuncture plus Pharmacotherapy
286(1)
Mini-Mental State Examination
287(1)
Hasegawa Dementia Scale
288(1)
Activities of Daily Living
289(1)
Safety of the Combination of Chinese Herbal Medicine plus Acupuncture
289(1)
Chinese Herbal Medicine plus Scalp Acupuncture Therapy
290(1)
Chinese Herbal Medicine plus Scalp Acupuncture vs. Pharmacotherapy
290(1)
Integrative Chinese Herbal Medicine plus Scalp Acupuncture vs. Pharmacotherapy
291(1)
Safety of the Combination of Chinese Herbal Medicine plus Scalp Acupuncture
291(1)
Chinese Herbal Medicine plus Acupuncture plus Rehabilitation Therapy
291(1)
Clinical Evidence for Commonly Used Interventions
292(1)
Summary of the Evidence for Combination Therapies
293(1)
References
294(3)
10 Summary and Conclusions 297(32)
Introduction
297(1)
Chinese Medicine Syndrome Differentiation
298(5)
Classical Literature
299(1)
Clinical Studies
299(4)
Chinese Herbal Medicine
303(6)
Classical Literature
303(1)
Clinical Studies
304(2)
Chinese Herbal Medicine Formulae in Key Clinical Guidelines and Textbooks, Classical Literature, and Clinical Studies
306(2)
GRADE Assessments
308(1)
Formula Ingredients
309(1)
Acupuncture and Related Therapies
309(7)
Clinical Evidence for Acupuncture and Electroacupuncture
310(1)
GRADE Assessments
311(1)
Scalp Acupuncture
311(1)
Moxibustion
312(1)
Ear Acupressure
312(1)
Acupuncture Points Used in Key Clinical Guidelines, Textbooks, Classical Literature, and Clinical Studies
313(3)
Other Chinese Medicine Therapies
316(1)
Other Chinese Medicine Therapies in Key Clinical Guidelines and Textbooks, Classical Literature, and Clinical Studies
317(1)
Limitations of the Evidence
317(4)
Evidence from Classical Literature
318(1)
Evidence from Clinical Studies
319(2)
Implications for Practice
321(3)
Herbal Formulae
321(1)
Herbs in Formulae
322(1)
Acupuncture Therapies
323(1)
Combination Therapies
323(1)
Safety
324(1)
Implications for Research
324(2)
References
326(3)
Glossary 329
Index 33