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艾灸治疗认知障碍:动物研究的系统评价与荟萃分析

Moxibustion for cognitive impairment: a systematic review and meta-analysis of animal studies.

作者信息

Aum Sungmin, Choe Seon, Cai Mudan, Jerng Ui Min, Lee Jun-Hwan

机构信息

University of Science and Technology (UST), Daejeon, Republic of Korea.

Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Integr Med Res. 2021 Jun;10(2):100680. doi: 10.1016/j.imr.2020.100680. Epub 2020 Oct 14.

Abstract

BACKGROUND

Cognitive impairment is an age-dependent chronic disorder that exponentially worsens with age; however, its treatment is mostly symptomatic. Moxibustion is widely accepted in East Asia as a treatment for cognitive impairment. This systematic review aimed to verify the efficacy and underlying mechanism of moxibustion in treating cognitive impairment.

METHODS

Sixteen trials involving 324 animals obtained from MEDLINE (PubMed), EMBASE, the Cochrane library, the Chinese National Knowledge Infrastructure, Wan-Fang, Cqvip, the Korean Studies Information Service System, and the Oriental Medicine Advanced Searching Integrated System met the inclusion criteria. We extracted the results of behavioral tests and immunohistochemical biomarkers from the included articles and evaluated the risk of bias and reporting quality.

RESULTS

The moxibustion group showed significantly decreased escape latency, increased crossing times, and prolonged dwelling times in the Morris water maze test. There was a significantly enhanced latency period and reduced error time in the step-down test and nerve behavior score. The effects of moxibustion were found to be mediated by suppression of oxidative stress and apoptosis, modulation of inflammation and Aβ genesis activation of vascular endothelial growth factor, and adjustment of metabolites in the tricarboxylic acid cycle and fatty acid metabolism.

CONCLUSION

Our results demonstrated the therapeutic efficacy of moxibustion on cognitive impairment and suggested the putative mechanism. However, considering the small number of included studies, high bias risk, low reporting quality, and the limitations of animal experimentation, our results need to be confirmed by more detailed studies.

摘要

背景

认知障碍是一种与年龄相关的慢性疾病,其严重程度会随年龄增长呈指数级恶化;然而,其治疗大多只是对症治疗。艾灸在东亚地区被广泛认可为治疗认知障碍的方法。本系统评价旨在验证艾灸治疗认知障碍的疗效及潜在机制。

方法

从MEDLINE(PubMed)、EMBASE、Cochrane图书馆、中国知网、万方、维普、韩国研究信息服务系统和东方医学高级检索集成系统中获取了16项涉及324只动物的试验,这些试验符合纳入标准。我们从纳入的文章中提取了行为测试结果和免疫组化生物标志物,并评估了偏倚风险和报告质量。

结果

在莫里斯水迷宫试验中,艾灸组的逃避潜伏期显著缩短,穿越次数增加,停留时间延长。在跳台试验和神经行为评分中,潜伏期显著延长,错误时间减少。发现艾灸的作用是通过抑制氧化应激和细胞凋亡、调节炎症和淀粉样蛋白生成、激活血管内皮生长因子以及调节三羧酸循环和脂肪酸代谢中的代谢产物来介导的。

结论

我们的结果证明了艾灸对认知障碍的治疗效果,并提出了可能的机制。然而,考虑到纳入研究数量较少、偏倚风险高、报告质量低以及动物实验的局限性,我们的结果需要通过更详细的研究来证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c2e/7972968/0aafbb0944cc/gr1.jpg

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