TABLE 2.
Quality of evidence in the included systematic reviews based on GRADE.
| References | Outcomes | No.of | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | No. of participants | Pooled effect size | 95% CI | Quality of evidence | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Intervention | Control | |||||||||||
| Yang et al. (2021) | ADL | 9 | −1 a | 0 | 0 | 0 | −1 b | 283 | 279 | MD = −1.30 | (-2.27, -0.33) | Low |
| MMSE | 10 | −1 a | −1 c | 0 | 0 | −1 b | 317 | 313 | MD = 1.17 | (0.15, 2.20) | Extremely low | |
| ADAS-Cog | 4 | −1 a | −2 d | 0 | −1 e | −1 b | 123 | 121 | MD = −4.69 | (-16.14, 6.75) | Extremely low | |
| TCM-SSS | 4 | −1 a | −2 d | 0 | −1 e | −1 b | 108 | 104 | MD = −4.70 | (-8.97, -0.43) | Extremely low | |
| AR | 7 | −1 a | NR | 0 | −1 e | NR | NR | NR | NR | NR | Not evaluated | |
| Wang et al. (2020) | ADL | 35 | −2 f | −2 d | 0 | −1 e | −1 b | 1,006 | 901 | MD = −1.00 | (-4.56, 2.56) | Extremely low |
| MMSE | 29 | −2 f | −2 d | 0 | 0 | −1 b | 1,348 | 1,229 | MD = 1.82 | (0.91, 2.72) | Extremely low | |
| AR | 8 | −2 f | NA | 0 | 0 | −1 b | NR | NR | NR | NR | Not evaluated | |
| TER | 39 | −2 f | 0 | 0 | 0 | −1 b | 1784 | 1,656 | RR = 1.14 | (1.03, 1.25) | Extremely low | |
| Li et al. (2019) | ADL | 5 | −1 a | −1 c | 0 | −1 e | −1 b | 187 | 169 | SMD = 0.27 | (-0.41, 0.95) | Not evaluated |
| MMSE | 8 | −2 f | −2 d | 0 | 0 | −1 b | 247 | 221 | WMD = 1.87 | (0.76, 2.98) | Extremely low | |
| AR | 1 | −2 f | NA | 0 | NR | NR | 24 | 22 | NR | NR | Not evaluated | |
| TER | 6 | −2 f | 0 | 0 | 0 | −1 b | 222 | 212 | RR = 1.29 | (1.16, 1.44) | Extremely low | |
| Qin et al. (2019) | ADL | 6 | −1 a | −2 d | 0 | −1 e | −1 b | 224 | 180 | WMD = −0.52 | (-0.76, -0.28) | Extremely low |
| MMSE | 8 | −1 a | −1 c | 0 | 0 | −1 b | 320 | 280 | WMD = 0.48 | (0.31, 0.64) | Extremely low | |
| ADAS-Cog | 3 | −1 a | −1 c | 0 | −1 e | −1 b | 92 | 90 | WMD = −0.41 | (-0.71, -0.11) | Extremely low | |
| AR | 5 | −1 a | −1 c | 0 | NR | NR | 192 | 150 | NR | NR | Not evaluated | |
| TER | 9 | −1 a | 0 | 0 | 0 | −1 b | 371 | 330 | OR = 3.37 | (2.35, 4.83) | Low | |
| Yang et al. (2019) | ADL | 5 | −2 f | −1 c | 0 | −1 e | −1 b | 165 | 161 | WMD = 0.81 | (-2.46, 0.83) | Extremely low |
| MMSE | 6 | −2 f | 0 | 0 | 0 | −1 b | 247 | 241 | WMD = 1.34 | (0.74, 1.95) | Extremely low | |
| AR | 7 | −2 f | −1 c | 0 | −1 e | NR | NR | NR | NR | NR | Not evaluated | |
| TRE | 7 | −2 f | 0 | 0 | 0 | −1 b | 205 | 201 | OR = 2.28 | (1.47, 3.52) | Extremely low | |
| Shi et al. (2019) | ADL | 4 | −2 f | −1 c | 0 | 0 | −1 b | 283 | 277 | MD = −3.40 | (-4.92, -1.87) | Extremely low |
| MMSE | 5 | −2 f | −2 d | 0 | 0 | −1 b | 314 | 308 | MD = 2.69 | (2.13, 3.26) | Extremely low | |
| AR | −2 f | −1 c | 0 | −1 e | −1 b | NR | NR | NR | NR | Not evaluated | ||
| TER | 3 | −2 f | 0 | 0 | −1 e | −1 b | 77 | 67 | RR = 1.27 | (1.08, 1.50) | Extremely low | |
| Chen et al. (2019) | ADL | 3 | −2 f | −1 c | 0 | −1 e | −1 b | 149 | 152 | MD = 10.48 | (8.33, 12.64) | Extremely low |
| AR | 5 | −2 f | 0 | 0 | 0 | −1 b | 234 | 237 | OR = 0.31 | (0.19, 0.49) | Extremely low | |
| TER | 9 | −2 f | 0 | 0 | 0 | −1 b | 412 | 415 | OR = 2.07 | (1.39, 3.07) | Extremely low | |
| Zhang et al. (2019) | ADL | 16 | −1 a | 0 | 0 | 0 | 0 | NR | NR | SMD = 0.38 | (0.25, 0.49) | Moderate |
| MMSE | 23 | −1 a | −1 c | 0 | 0 | 0 | NR | NR | SMD = 0.66 | (0.44, 0.89) | Low | |
| Du et al. (2017) | ADL | 5 | −2 f | 0 | 0 | −1 e | −1 b | 160 | 156 | MD = −3.60 | (-4.53, -2.66) | Extremely low |
| MMSE | 7 | −2 f | −1 c | 0 | 0 | −1 b | 238 | 238 | MD = 2.69 | (1.46, 3.92) | Extremely low | |
| ADAS-Cog | 3 | −2 f | −1 c | 0 | −1 e | −1 b | 88 | 83 | MD = −4.54 | (-5.64, -3.43) | Extremely low | |
| Ma et al. (2018) | CDR | 1 | −1 a | −1 c | 0 | −1 e | −1 b | 31 | 15 | MD = −0.40 | (-0.69, -0.11) | Extremely low |
| ADL | NA | −1 a | −1 c | 0 | −1 e | −1 b | NR | NR | MD = 0.94 | (-1.54, 3.43) | Extremely low | |
| MMSE | 5 | −1 a | 0 | 0 | −1 e | −1 b | 114 | 109 | MD = 0.69 | (-0.17, 1.56) | Extremely low | |
| AR | NA | −1 a | −1 c | 0 | −1 e | −1 b | NR | NR | NR | NR | Not evaluated | |
| Xu and Xie, (2015) | MMSE | 4 | −2 f | −1 c | 0 | −1 e | −1 b | 125 | 126 | MD = 2.87 | (0.64, 5.10) | Extremely low |
| TER | 7 | −2 f | 0 | 0 | 0 | −1 b | 278 | 246 | OR = 1.25 | (1.14, 1.38) | Extremely low | |
| Zeng et al. (2015) | MMSE | 15 | −1 a | −1 c | 0 | −1 e | −1 b | 717 | 575 | MD = 0.79 | (-0.11, 1.69) | Extremely low |
| AR | −1 a | −1 c | 0 | −1 e | −1 b | NR | NR | NR | NR | Not evaluated | ||
| TER | 15 | −1 a | 0 | 0 | 0 | −1 b | 717 | 575 | OR = 1.09 | (0.82, 1.46) | Low | |
NR, Not reported; TCM-SSS, Traditional Chinese Medicine syndrome score scale; ADL, Activies Daily Living; MMSE, Mini-mental State Examination; ADAS-Cog, Alzheimer’s Disease Assessment Scale-Cognitive section; AR, adverse reactions; TER, total effective rate; SMD, standard mean difference; MD, mean difference; OR, odds ratio.
The included studies have a high risk of bias in terms of randomization, blinding, allocation concealment, completeness of result data, or selective reporting.
Asymmetric funnel plot or less than nine studies.
75% ≤ I 2 ≤ 100%.
50% ≤ I 2 < 75%.
small sample studies accounted for the majority.
The included studies have two or more high risks of bias in terms of randomization, blinding, allocation concealment, completeness of result data, or selective reporting.