Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
Yuangang Street Community Health Service Center, Guangzhou, China.
Medicine (Baltimore). 2023 Jun 9;102(23):e33989. doi: 10.1097/MD.0000000000033989.
Vascular dementia is a cognitive dysfunction syndrome caused by cerebral vascular factors such as ischemic stroke and hemorrhagic stroke. The effect of acupuncture on vascular dementia models is ambiguous, and there is controversy about whether acupuncture has a placebo effect. Oxidative stress and inflammation are the most essential mechanisms in preclinical studies of vascular dementia. However, there is no meta-analysis on the mechanism of vascular dementia in animal models. It is necessary to explore the efficacy of acupuncture through Meta-analysis of preclinical studies.
Three major databases, PubMed, Embase and Web of Science (including medline), were searched in English until December 2022.The quality of the including literature was assessed using SYRCLE's risk of bias tool. Review Manager 5.3 was used to statistically summarize the included studies and the statistical effect values were expressed by SMD. The outcomes included: behavioral tests (escape latency, number of crossings), pathological sections (Nissl and TUNEL staining), oxidative stress markers (ROS, MDA, SOD, GSH-PX) and neuroinflammatory factors (TNF-α, IL-1β, IL-6).
A total of 31 articles were included in this meta-analysis. The results showed that the escape latency, the contents of ROS, MDA, IL-1β, and IL-6 were decreased, and the contents of SOD and Nissl-positive neurons were increased in the acupuncture group as compared with the non-group (P < .05). Compared with the impaired group, the acupuncture group also had the above advantages (P < .05). In addition, the acupuncture group also increased the number of crossings and GSH-PX content, and decreased the expression of TUNEL-positive neurons and TNF-α (P < .05).
From behavioral tests to slices and pathological markers in animal models of vascular dementia, it can be proved that acupuncture is effective in targeting oxidative stress and neuroinflammatory damage, and acupuncture is not a placebo effect. Nevertheless, attention needs to be paid to the gap between animal experiments and clinical applications.
血管性痴呆是一种由缺血性卒中和出血性卒中等脑血管因素引起的认知功能障碍综合征。针灸对血管性痴呆模型的影响尚不清楚，针灸是否具有安慰剂效应存在争议。氧化应激和炎症是血管性痴呆临床前研究中最基本的机制。然而，目前还没有关于动物模型血管性痴呆机制的荟萃分析。有必要通过临床前研究的荟萃分析来探讨针灸的疗效。
以英文检索 PubMed、Embase 和 Web of Science（包括 medline）三大数据库，检索时间截至 2022 年 12 月。使用 SYRCLE 的偏倚风险工具评估纳入文献的质量。采用 Review Manager 5.3 对纳入研究进行统计学汇总，统计效应值用 SMD 表示。结局指标包括：行为学测试（逃避潜伏期、穿越次数）、病理切片（尼氏染色和 TUNEL 染色）、氧化应激标志物（ROS、MDA、SOD、GSH-PX）和神经炎症因子（TNF-α、IL-1β、IL-6）。
共纳入 31 篇文章进行荟萃分析。结果显示，与非针刺组相比，针刺组的逃避潜伏期、ROS、MDA、IL-1β、IL-6 含量降低，SOD 和尼氏阳性神经元含量增加（P<0.05）。与模型组相比，针刺组也具有上述优势（P<0.05）。此外，针刺组还增加了穿越次数和 GSH-PX 含量，减少了 TUNEL 阳性神经元和 TNF-α的表达（P<0.05）。
从行为学测试到血管性痴呆动物模型的切片和病理标志物，都可以证明针灸对氧化应激和神经炎症损伤有治疗作用，针灸不是安慰剂效应。然而，需要注意动物实验与临床应用之间的差距。
