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针灸相关治疗改善阿尔茨海默病的认知和身体功能:一项随机对照试验的系统评价和荟萃分析

Acupuncture-related treatments improve cognitive and physical functions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Lin Chuan-Ju, Yeh Mei-Ling, Wu Shu-Fang, Chung Yu-Chu, Lee Justin Chen-Hao

机构信息

145469Hsinchu Cathay General Hospital, Hsinchu, Taiwan; National Taipei University of Nursing and Health Sciences, Taipei.

38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.

出版信息

Clin Rehabil. 2022 May;36(5):609-635. doi: 10.1177/02692155221079117. Epub 2022 Mar 1.

Abstract

OBJECTIVE

To determine acupuncture-related treatments' effects and duration on improving cognitive function, physical function, and quality of life in patients with Alzheimer's disease.

DATA SOURCES

Eight electronic databases were searched for eligible randomized controlled trials from database inception to January 2021, including Medline, PubMed, EBSCO, Embase, Cochrane, Airiti Library, China National Knowledge Infrastructure, and China Journal Full-text Database.

REVIEW METHODS

A systematic review and meta-analysis were conducted on acupuncture types, cognitive function, activity of daily life, muscle strength and quality of life.

RESULTS

Sixty-six studies in total with 4191 participants, the overall risk of bias was classified 60% as low and 24% as high. Acupuncture-related treatments for cognitive function and self-care ability revealed a moderate effect size, with a significant difference in noninvasive and invasive remedies ( < 0.001). Cognitive function showed significant differences in 6, 8, 12, and 24 weeks while self-care ability in the latter two weeks ( < 0.001). Meta-regression analysis showed cognitive function increased by 0.05 points ( = 0.002) and self-care ability decreased by 0.02 points ( = 0.04) after weekly treatment. There was a significant difference in muscle strength ( = 0.0003).

CONCLUSION

Acupuncture-related treatments effectively improved cognitive function with the treatment lasted 6 weeks at least, but self-care ability started showing effects after 12 weeks of treatment. The improvement of muscle strength was also confirmed. Acupuncture-related treatments, particularly noninvasive ones, have few complications and high safety, perhaps providing patients and caregivers diversified choices and clinical care guidelines for reference.

摘要

目的

确定针灸相关治疗对改善阿尔茨海默病患者认知功能、身体功能和生活质量的效果及持续时间。

数据来源

检索了8个电子数据库,以查找从数据库建立至2021年1月符合条件的随机对照试验,包括医学索引数据库、医学期刊数据库、EBSCO、荷兰医学文摘数据库、考克兰系统评价数据库、华艺数位艺术文献数据库、中国知网和中国期刊全文数据库。

综述方法

对针灸类型、认知功能、日常生活活动、肌肉力量和生活质量进行系统评价和荟萃分析。

结果

共有66项研究,4191名参与者,总体偏倚风险60%为低,24%为高。针灸相关治疗对认知功能和自我护理能力显示出中等效应量,非侵入性和侵入性疗法存在显著差异(<0.001)。认知功能在6周、8周、12周和24周时显示出显著差异,而自我护理能力在最后两周显示出显著差异(<0.001)。Meta回归分析显示,每周治疗后认知功能提高0.05分(=0.002),自我护理能力下降0.02分(=0.04)。肌肉力量存在显著差异(=0.0003)。

结论

针灸相关治疗能有效改善认知功能,治疗至少持续6周,但自我护理能力在治疗12周后才开始显现效果。肌肉力量的改善也得到了证实。针灸相关治疗,尤其是非侵入性治疗,并发症少,安全性高,可能为患者和护理人员提供多样化的选择及临床护理参考指南。

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