Zhou Liang, Wang Yao, Qiao Jun, Wang Qing Mei, Luo Xun
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, China.
Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, China.
Front Psychol. 2020 Nov 30;11:549265. doi: 10.3389/fpsyg.2020.549265. eCollection 2020.
This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients. Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software. Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2-8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], < 0.00001). The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.
这项荟萃分析评估了针刺改善中风后患者认知障碍的疗效。从数据库（PubMed、EMBASE、Ovid库、Cochrane图书馆、中国知网、维普中文期刊数据库、万方数据库和中国生物医学文献数据库）中检索出2019年12月之前调查针刺与不治疗或假针刺相比对中风后认知障碍（PSCI）影响的随机对照试验（RCT）。文献检索和数据提取由两名研究者独立进行。采用Cochrane干预系统评价手册评估研究质量。使用Revman 5.3软件对符合条件的RCT进行荟萃分析。本荟萃分析纳入了37项RCT（2869例患者）。计算针刺与不针刺或假针刺比较时MMSE（简易精神状态检查表）或MoCA（蒙特利尔认知评估量表）得分增加的合并随机效应估计值。针刺干预2至8周后，汇总结果显示针刺在改善PSCI方面有显著效果，MMSE评估结果为（MD [95%CI] = 2.88 [2.09, 3.66]，<0.00001），MoCA评估结果为（MD [95%CI] = 2.66 [1.95, 3.37]，<0.00001）。结果表明，针刺在改善PSCI方面有效，并支持需要进行更严格设计的大规模随机临床试验以确定其治疗益处。
