Liu Fang, Li Zhuang-Miao, Jiang Yi-Jing, Chen Li-Dian
1 Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine , Fuzhou, China .
J Altern Complement Med. 2014 Jul;20(7):535-44. doi: 10.1089/acm.2013.0364. Epub 2014 Jun 10.
This meta-analysis was conducted to evaluate the efficacy of acupuncture on cognitive impairment (function) after a stroke.
Randomized controlled trials (RCTs) comparing acupuncture with no acupuncture in addition to medicine or rehabilitation were identified from databases (PubMed, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wangfang Chinese Periodical Database, Chinese Bio-medicine Database, Cochrane Library, and Chinese medical literature databases) and two relevant journals (Chinese Acupuncture and Moxibustion and the Journal of Shanghai Acupuncture and Moxibustion). Meta-analyses were conducted for the eligible RCTs.
Twenty-one trials with a total of 1421 patients met inclusion criteria. Pooled random-effects estimates of the change in the Mini-Mental State Examination were calculated for the comparison of acupuncture with no acupuncture in addition to medicine or rehabilitation. Following 4 weeks and 8 weeks of intervention with acupuncture, the merged mean difference was 3.14 (95% confidence interval [CI], 2.06-4.21; p<.00001) and 2.03 (95% CI, 0.26-3.80; p=0.02), respectively. For the comparison of 3-4 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the merged MD in Neurobehavioral Cognitive State Examination total scores was 5.63 (95% CI, 3.95-7.31; p<.00001). For the comparison of 8-12 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the P300 latency merged MD was -12.80 (95% CI, -21.08 to -4.51; p<.00001), while the P300 amplitude merged MD was 1.38 (95% CI, 0.93-1.82; p<.00001). Overall, the study quality was rated as moderate on the basis of the Cochrane Handbook for Systematic Reviews of Interventions (part 2: 8.5).
This meta-analysis suggests that acupuncture had positive effects on cognitive function after stroke and supports the need for additional research on the potential benefits of this therapeutic approach.
进行此项荟萃分析以评估针刺对中风后认知障碍（功能）的疗效。
从数据库（PubMed、Cochrane对照试验中央注册库、中国知网、维普中文期刊数据库、万方中文期刊数据库、中国生物医学数据库、Cochrane图书馆以及中国医学文献数据库）和两本相关期刊（《中国针灸》和《上海针灸杂志》）中检索比较针刺联合药物或康复治疗与单纯药物或康复治疗（不进行针刺）的随机对照试验（RCT）。对符合条件的RCT进行荟萃分析。
21项试验共1421例患者符合纳入标准。计算针刺联合药物或康复治疗与单纯药物或康复治疗（不进行针刺）比较时简易精神状态检查表变化的合并随机效应估计值。针刺干预4周和8周后，合并平均差值分别为3.14（95%置信区间[CI]，2.06 - 4.21；p<0.00001）和2.03（95%CI，0.26 - 3.80；p = 0.02）。针刺3 - 4周组与单纯药物或康复治疗（不进行针刺）组比较时，神经行为认知状态检查表总分的合并平均差值为5.63（95%CI，3.95 - 7.31；p<0.00001）。针刺8 - 12周组与单纯药物或康复治疗（不进行针刺）组比较时，P300潜伏期合并平均差值为 - 12.80（95%CI， - 21.08至 - 4.51；p<0.00001），而P300波幅合并平均差值为1.38（95%CI，0.93 - 1.82；p<0.00001）。总体而言，根据《Cochrane干预措施系统评价手册》（第2部分：8.5），研究质量被评为中等。
此项荟萃分析表明针刺对中风后的认知功能有积极影响，并支持对这种治疗方法的潜在益处进行更多研究的必要性。
