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针灸治疗血管性痴呆患者的有效性:系统评价和荟萃分析。

Effectiveness of acupuncture for patients with vascular dementia: A systematic review and meta-analysis.

机构信息

The Fifth Department of Acupuncture, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China.

Heilongjiang University of Chinese Medicine, Harbin 150040, China.

出版信息

Complement Ther Med. 2022 Nov;70:102857. doi: 10.1016/j.ctim.2022.102857. Epub 2022 Jul 16.

Abstract

OBJECTIVES

This meta-analysis assessed the treatment effectiveness of acupuncture in patients with vascular dementia.

METHODS

The PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure were searched to identify eligible randomized controlled trials (RCTs). The odds ratios (ORs) and weighted mean differences (WMDs) with 95 % confidence intervals (CIs) were used to assess the pooled effect estimates using a random-effects model for categorical and continuous outcomes, respectively.

RESULTS

Thirty-four RCTs (2672 patients) were selected for the final meta-analysis. The use of acupuncture showed association with an increased incidence of effective rate (OR: 3.28; 95 % CI: 2.54-4.24; P < 0.001). The pooled WMDs revealed that acupuncture was significantly associated with an improvement in the Hasegawa dementia scale (HDS) (WMD: 4.31; 95 % CI: 3.15-5.47; P < 0.001), and Mini-Mental State Examination scores (MMSE) (WMD: 3.07; 95 % CI: 2.40-3.74; P < 0.001). However, the use of acupuncture showed no association with the level of Activities of daily living (ADL) (WMD: 1.93; 95 % CI: - 2.53 to 6.38; P = 0.397). Finally, acupuncture was associated with lower levels of Scale for the differentiation of syndromes of vascular dementia (SDSVD) (WMD: - 2.15; 95 % CI: - 4.14 to - 0.16; P = 0.034), and National Institutes of Health stroke scale (NIHSS) (WMD: - 3.90; 95 % CI: - 4.87 to - 2.94; P < 0.001).

CONCLUSIONS

Acupuncture is probably helpful in vascular stroke, but strong supportive data are not yet available. Acupuncture should be used cautiously, owing to the analysis of this study based on low to moderate evidence. Further high-quality, large-scale RCTs should be conducted.

摘要

目的

本荟萃分析评估了针灸治疗血管性痴呆患者的疗效。

方法

检索 PubMed、Embase、Cochrane 图书馆和中国知网,以确定合格的随机对照试验(RCT)。使用随机效应模型分别对分类和连续结局评估汇总效应估计值的比值比(OR)和加权均数差值(WMD)及其 95%置信区间(CI)。

结果

最终纳入 34 项 RCT(2672 例患者)进行荟萃分析。使用针灸与有效率的增加相关(OR:3.28;95%CI:2.54-4.24;P<0.001)。荟萃分析的 WMD 表明,针灸与哈塞格瓦痴呆量表(HDS)评分的改善显著相关(WMD:4.31;95%CI:3.15-5.47;P<0.001)和简易精神状态检查评分(MMSE)(WMD:3.07;95%CI:2.40-3.74;P<0.001)。然而,针灸与日常生活活动能力(ADL)水平无关(WMD:1.93;95%CI:-2.53-6.38;P=0.397)。最后,针灸与血管性痴呆证候鉴别量表(SDSVD)评分降低相关(WMD:-2.15;95%CI:-4.14 至 -0.16;P=0.034)和美国国立卫生研究院卒中量表(NIHSS)评分降低相关(WMD:-3.90;95%CI:-4.87 至 -2.94;P<0.001)。

结论

针灸可能对血管性中风有帮助,但目前还没有强有力的支持数据。由于本研究的分析基于低到中等质量的证据,因此应谨慎使用针灸。应进行进一步的高质量、大规模 RCT。

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