Zhou Qiongyang, Ji Yue, Lv Yanzhu, Xue Jing, Wang Yuhui, Huang Yin
Department of Acupuncture and Moxibustion, The First People's Hospital of Wenling, Wenling, People's Republic of China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Jul 3;19:1503-1513. doi: 10.2147/NDT.S407162. eCollection 2023.
Acupuncture may be effective to treat post-stroke cognitive impairment (PSCI). We aimed to evaluate the reliability of the systematic reviews/meta-analyses (SRs/MAs) evidence regarding acupuncture treatment of PSCI.
The methodological quality was appraised with Methodological Quality of Systematic Reviews 2 (AMSTAR-2). We evaluated reporting quality with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and evidence quality with Grade of Recommendation, Assessment, Development and Evaluation (GRADE) system.
The inclusion criteria were met by fifteen reviews. All studies assessed by AMSTAR-2 had critically poor methodological quality due to the limitations on the lack of the provision of the list of excluded trails, screening of duplicate study, and protocol registration. For reporting quality, response rate of "yes" was less than 50% in Q5 (protocol and registration topic), Q8 (Search) and Q23 (Additional analysis). Evidence quality of outcome measures was low or worse with GRADE because when the data was qualitatively synthesized, low quality and small sample size trials provided the data.
Acupuncture may be beneficial for PSCI. Because of limitations and inconsistent conclusions, further research is needed to provide higher evidence for acupuncture on PSCI.
针灸可能对治疗中风后认知障碍（PSCI）有效。我们旨在评估关于针灸治疗PSCI的系统评价/荟萃分析（SRs/MAs）证据的可靠性。
采用系统评价方法学质量2（AMSTAR-2）评估方法学质量。我们用系统评价和荟萃分析的首选报告项目（PRISMA）评估报告质量，并用推荐分级、评估、制定与评价（GRADE）系统评估证据质量。
15项评价符合纳入标准。由于缺乏排除试验清单、重复研究筛查和方案注册等限制，所有经AMSTAR-2评估的研究方法学质量都非常差。在报告质量方面，Q5（方案和注册主题）、Q8（检索）和Q23（额外分析）中“是”的回答率低于50%。结局指标的证据质量用GRADE评估为低或更差，因为在定性合成数据时，低质量和小样本量试验提供了数据。
针灸可能对PSCI有益。由于存在局限性和结论不一致，需要进一步研究为针灸治疗PSCI提供更高质量的证据。
