The effectiveness of Bushen Yizhi Decoction for vascular dementia patients: A systematic review and meta-analysis

Abstract

Introduction

Vascular dementia (VD), a highly prevalent neuropsychiatric disorder, predominantly impacts the elderly. The complex, multifaceted pathogenesis of VD makes it difficult for Western medicine (WM) to effectively address its wide range of symptoms when used in isolation. Consequently, multi-channel intervention has surfaced as the principal approach for the prophylaxis and treatment of VD. In recent times, there has been a mounting enthusiasm for Traditional Chinese Medicine (TCM) in the management of VD, with Bushen Yizhi Decoction (BSYZD) being a notable example. This systematic review and meta-analysis were designed to appraise the therapeutic effects of BSYZD in patients afflicted with VD.

Methods

Randomized controlled trials (RCTs) centering around BSYZD for the treatment of VD were comprehensively searched within a diverse range of databases, namely PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WanFang, and SinoMed, with the search period extending up to January 2026. Review Manager 5.4 and Stata 16.0 were strategically employed to conduct a meticulous analysis and synthesis of the retrieved data. Moreover, relevant literature citations were scrupulously retrieved, and a painstaking hand search of pertinent journals was also carried out. Methodological quality and risk of bias for all included RCTs were systematically evaluated using the Cochrane Collaboration’s Risk of Bias 2.0 (RoB 2.0) tool. The overall quality of evidence in the study was assessed by using the GRADE approach.

Results

Finally, 206 documents were initially retrieved, and after removing 108 duplicates, 30 RCTs were finally included for analysis. A total of thirty randomized controlled trials, encompassing 2408 individuals, were ultimately incorporated. The meta-analysis demonstrated that BSYZD had a significant impact. It was found to effectively reduce the Activities of Daily Living scale (ADL) (1) [WMD = -6.36; 95% CI (-8.97, -3.75); P < 0.00001] and the Clinical Dementia Rating (CDR) [WMD = -0.52; 95% CI (-0.75, -0.29); P < 0.00001]. Simultaneously, it could enhance the Mini-mental State Examination (MMSE) [WMD = 3.01; 95% CI (2.35, 3.67); P < 0.00001], Activities of Daily Living scale (ADL) (2) [WMD = 10.16; 95% CI (4.32, 16.00); P = 0.0007], Hasegawa Dementia Scale (HDS) [WMD = 4.55; 95% CI (3.98, 5.12); P < 0.00001], Berg Balance Scale (BBS) [WMD = 5.62; 95% CI (4.04, 7.19); P < 0.00001], and Wechsler Memory Scale (WMS) [WMD = 7.44; 95% CI (4.66, 10.22); P < 0.00001]. Subgroup analysis further disclosed that regardless of whether BSYZD was administered alone or in conjunction with western medicine, it was capable of augmenting the overall therapeutic efficacy.

Discussion

This meta-analysis conclusively reveals that BSYZD has the potential to serve as an efficacious treatment alternative for patients grappling with vascular dementia. Nevertheless, in light of the restricted quantity and suboptimal quality of the incorporated articles, the derived results mandate verification through supplementary high-caliber, large-scale sample, and multi-center RCTs.