补充和整合医学治疗痴呆的行为和心理症状：系统评价概述。

Complementary and integrative medicines for behavioral and psychological symptoms of dementia: Overview of systematic reviews.

机构信息

Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, 52-57, Yangjeong-ro, Busanjin-gu, Busan, Republic of Korea.

KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.

出版信息

Explore (NY). 2023 Mar-Apr;19(2):176-194. doi: 10.1016/j.explore.2022.08.005. Epub 2022 Aug 11.

DOI:10.1016/j.explore.2022.08.005

PMID:35973932

Abstract

BACKGROUND

Behavioral and psychological symptoms of dementia (BPSDs) are major contributing factors to disease burden in dementia patients. Complementary and integrative medicine (CIM) has received attention in the management of dementia in patients with BPSDs. This overview aimed to comprehensively and critically review previous systematic reviews (SRs) of CIM modalities for BPSD management.

METHODS

Thirteen databases were searched in November 2021 to identify SRs on CIM for BPSDs. The methodological quality of the included studies was assessed using A MeaSurement Tool to Assess systematic Reviews 2.

RESULTS

Among 38 SRs, aromatherapy was the most commonly studied intervention, followed by herbal medicine (HM), acupuncture/acupressure, mindfulness-based interventions, relaxation, and Taichi. Half of the studies on aromatherapy reported significantly improved BPSDs, especially agitation, while the remainder reported mixed results/insufficient evidence. Most studies (85.71%) on HM supported its significant benefits in BPSDs. Yokukansan, an individual HM, was most frequently studied for BPSDs, with a significant beneficial effect on delusions, hallucinations, and agitation/aggression. Moreover, some meta-analyses supported the benefits of HM as an adjunct to psychotropic drugs in BPSD management. Other CIM interventions had insufficient clinical evidence. The methodological quality of the included studies was poor, and most were rated low or critically low (92.11%).

CONCLUSION

Aromatherapy, the most frequently investigated CIM for BPSD, had mixed results or insufficient evidence. HM, as an adjunct to psychotropic drugs including antipsychotics, exhibited additional benefits regarding the efficacy and safety for BPSDs. This overview emphasizes the requirement for greater quantity and quality of research in this field.

REGISTRATION NUMBER

Open Science Framework registry (g5f3m) (https://osf.io/g5f3m), PROSPERO (CRD42020211009) (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020211009).

摘要

背景

痴呆患者的行为和心理症状（BPSD）是导致疾病负担的主要因素。补充和整合医学（CIM）在痴呆患者 BPSD 的管理中受到关注。本综述旨在全面、批判性地回顾 CIM 治疗 BPSD 的先前系统评价（SR）。

方法

2021 年 11 月，我们检索了 13 个数据库，以确定关于 CIM 治疗 BPSD 的 SR。使用 A MeaSurement Tool to Assess systematic Reviews 2 评估纳入研究的方法学质量。

结果

在 38 项 SR 中，最常研究的干预措施是芳香疗法，其次是草药（HM）、针灸/按摩、正念干预、放松和太极。半数芳香疗法研究报告 BPSD 明显改善，尤其是躁动，其余研究报告混合结果/证据不足。大多数 HM 研究（85.71%）支持其在 BPSD 中的显著益处。作为一种 HM，Yokukansan 最常用于治疗 BPSD，对妄想、幻觉和躁动/攻击有显著的有益作用。此外，一些荟萃分析支持 HM 作为辅助精神药物治疗 BPSD 的益处。其他 CIM 干预措施的临床证据不足。纳入研究的方法学质量较差，大多数研究被评为低或极低（92.11%）。