Li Liuying, Yang Lanying, Luo Biao, Deng Lvyu, Zhong Yue, Gan Daohui, Wu Xiaohan, Feng Peimin, Zhu Fengya
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
Traditional Chinese Medicine Department, Zigong First People's Hospital, Zigong, People's Republic of China.
Int J Gen Med. 2022 Sep 13;15:7249-7264. doi: 10.2147/IJGM.S376759. eCollection 2022.
Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke. In recent years, as a complementary alternative therapy, many systematic reviews (SRs) and meta-analysis (MAs) have reported the efficacy and safety of acupuncture in improving cognitive function in patients with PSCI, but the quality of evidence is unknown and therefore needs to be evaluated comprehensively.
We aimed to evaluate the SRs of acupuncture for patients with PSCI, to summarize the evidence quality of SRs to provide scientific evidence.
We searched for relevant SRs and MAs in seven databases up to March 22, 2022. Two reviewers independently completed literature retrieval, screening, and data extraction. We used A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) to evaluate the methodological quality; the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool to determine the strength of evidence; and the ROBIS tool to assess RoB.
We identified 14 SRs. The methodological quality of all SRs was low (2/14) or very low (12/14). GRADE results showed 13 were moderate quality (26%), 5 were low quality (10%), and 32 were very-low quality (64%). RoB showed that one SR had a low risk and 13 had a high risk. Moderate quality results showed that combined acupuncture therapy was superior to western medicine or cognitive rehabilitation training in improving cognitive function, the total response rate, and the daily living ability of patients with PSCI.
Based on the evidence, acupuncture appears to be effective and safe in improving cognitive function for patients with PSCI, but the overall quality of SRs is not high. High-quality randomized controlled trials are needed to confirm the effectiveness and safety of acupuncture on the cognitive function of patients with PSCI.
PROSPERO CRD42022315441.
卒中后认知障碍（PSCI）是卒中后最常见的并发症之一。近年来，作为一种补充替代疗法，许多系统评价（SRs）和荟萃分析（MAs）报告了针刺改善PSCI患者认知功能的有效性和安全性，但证据质量未知，因此需要进行全面评估。
我们旨在评估针刺治疗PSCI患者的系统评价，总结系统评价的证据质量以提供科学依据。
截至2022年3月22日，我们在7个数据库中检索相关的系统评价和荟萃分析。两名评价者独立完成文献检索、筛选和数据提取。我们使用系统评价的测量工具2（AMSTAR 2）评估方法学质量；使用推荐分级评估、制定与评价（GRADE）工具确定证据强度；使用ROBIS工具评估偏倚风险（RoB）。
我们纳入了14项系统评价。所有系统评价的方法学质量均为低质量（2/14）或极低质量（12/14）。GRADE结果显示，13项为中等质量（26%），5项为低质量（10%），32项为极低质量（64%）。RoB显示，1项系统评价偏倚风险低，13项偏倚风险高。中等质量的结果表明，联合针刺疗法在改善PSCI患者的认知功能、总有效率和日常生活能力方面优于西医或认知康复训练。
基于现有证据，针刺改善PSCI患者认知功能似乎是有效和安全的，但系统评价的整体质量不高。需要高质量的随机对照试验来证实针刺对PSCI患者认知功能的有效性和安全性。
PROSPERO CRD42022315441。
