Lam Wai Ching, Wei Dongjue, Li Huijuan, Yao Liang, Zhang Shiping, Lai Michael X Y, Zheng Ya, Yeung Jerry W F, Lau Alexander Y L, Lyu Aiping, Bian Zhaoxiang, Cheung Angela M, Zhong Linda L D
Biomedical Sciences and Chinese Medicine, School of Biological Sciences, Nanyang Technological University, Singapore, Singapore.
Chinese Medicine Teaching and Research Division, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.
Front Neurol. 2024 Jul 19;15:1406475. doi: 10.3389/fneur.2024.1406475. eCollection 2024.
Acupuncture has been used to treat neurological and neuropsychiatric symptoms in China and other parts of the world. These symptoms, such as fatigue, headache, cognitive impairment, anxiety, depression, and insomnia, are common in people experiencing long COVID.
This study aims to explore the feasibility of acupuncture in the treatment of neurological and neuropsychiatric symptoms in long COVID patients.
A systematic search was conducted in four English and four Chinese databases from inception to 23 June 2023. Literature selection and data extraction were conducted by two pairs of independent reviewers.
Randomized controlled trials (RCTs) that explored the effect of acupuncture on fatigue, depression, anxiety, cognitive abnormalities, headache, and insomnia were included.
RCTs that explored the effect of acupuncture on fatigue, depression, anxiety, cognitive abnormalities, headache, and insomnia were included. A meta-analysis was performed using R software. Heterogeneity was measured using I. Subgroup analyses were performed focusing on the duration of treatment and acupuncture modalities. The systematic review protocol was registered on PROSPERO (registration number: CRD42022354940).
Widely adopted clinical outcome scales included the Fatigue Scale for assessing fatigue, the Hamilton Depression Rating Scale for evaluating depression, the Mini-Mental State Examination for assessing cognitive impairment, the Visual Analog Scale for headache severity, and the Pittsburgh Sleep Quality Index for measuring insomnia.
A total of 110 RCTs were included in the systematic review and meta-analysis. Overall, acupuncture was found to improve the scores of the Fatigue Scale (vs. medication: mean differences (MD): -2.27, < 0.01; vs. sham acupuncture: MD: -3.36, < 0.01), the Hamilton Depression Rating Scale (vs. medication: MD: -1.62, 95%, < 0.01; vs. sham acupuncture: MD: -9.47, < 0.01), the Mini-Mental State Examination (vs. medication: MD: 1.15, < 0.01; vs. sham acupuncture: MD: 1.20, < 0.01), the Visual Analog Scale (vs. medication: MD: -1.05, < 0.01; vs. waitlist: MD: -0.48, P=0.04), and the Pittsburgh Sleep Quality Index (vs. medication: MD: -2.33, < 0.01; vs. sham acupuncture: MD: -4.19, < 0.01).
This systematic review suggested acupuncture as a potentially beneficial approach for the treatment of neurological and neuropsychiatric symptoms, as assessed using clinical scales, and it may have applicability in long COVID patients. Further well-designed clinical studies specifically targeting long COVID patients are needed to validate the role of acupuncture in alleviating long COVID symptoms.
PROSPERO, identifier [CRD42022354940].
在中国和世界其他地区，针灸已被用于治疗神经和神经精神症状。这些症状，如疲劳、头痛、认知障碍、焦虑、抑郁和失眠，在长期感染新冠病毒的人群中很常见。
本研究旨在探讨针灸治疗长期感染新冠病毒患者神经和神经精神症状的可行性。
从数据库建立至2023年6月23日，在四个英文数据库和四个中文数据库中进行了系统检索。文献筛选和数据提取由两对独立的评审人员进行。
纳入探讨针灸对疲劳、抑郁、焦虑、认知异常、头痛和失眠影响的随机对照试验（RCT）。
纳入探讨针灸对疲劳、抑郁、焦虑、认知异常、头痛和失眠影响的RCT。使用R软件进行荟萃分析。使用I统计量测量异质性。针对治疗持续时间和针灸方式进行亚组分析。该系统评价方案已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42022354940）。
广泛采用的临床结局量表包括用于评估疲劳的疲劳量表、用于评估抑郁的汉密尔顿抑郁评定量表、用于评估认知障碍的简易精神状态检查表、用于评估头痛严重程度的视觉模拟量表以及用于测量失眠的匹兹堡睡眠质量指数。
系统评价和荟萃分析共纳入110项RCT。总体而言，发现针灸可提高疲劳量表得分（与药物治疗相比：平均差（MD）：-2.27，P<0.01；与假针灸相比：MD：-3.36，P<0.01）、汉密尔顿抑郁评定量表得分（与药物治疗相比：MD：-1.62，95%CI，P<0.01；与假针灸相比：MD：-9.47，P<0.01）、简易精神状态检查表得分（与药物治疗相比：MD：1.15，P<0.01；与假针灸相比：MD：1.20，P<0.01）、视觉模拟量表得分（与药物治疗相比：MD：-1.05，P<0.01；与等待列表相比：MD：-0.48，P=0.04）以及匹兹堡睡眠质量指数得分（与药物治疗相比：MD：-2.33，P<0.01；与假针灸相比：MD：-4.19，P<0.01）。
本系统评价表明，针灸作为一种使用临床量表评估的、治疗神经和神经精神症状的潜在有益方法，可能适用于长期感染新冠病毒患者。需要针对长期感染新冠病毒患者开展进一步精心设计的临床研究，以验证针灸在缓解长期新冠症状中的作用。
国际前瞻性系统评价注册库（PROSPERO），标识符[CRD42022354940]
