An Wenzhuo, Guo Dongqing, Wang Jie, Chu Xin
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
PLoS One. 2025 Aug 12;20(8):e0329397. doi: 10.1371/journal.pone.0329397. eCollection 2025.
Non-pharmacological intervention represents a significant therapeutic modality for the cognitive function intervention management of patients with type 2 diabetes accompanied by mild cognitive impairment. However, it remains unclear which intervention measure is the most effective. The objective of this study is to compare and rank the influences of various non-pharmacological interventions on the cognitive function of patients with type 2 diabetes and mild cognitive impairment.
Eight databases from the establishment of the database to November 2024 were retrieved. The quality of the literature was evaluated using the RoB2.0 tool. Paired Meta-analysis was conducted using Stata/SE 15.1 software, and Network Meta-analysis was performed using R 4.3.1 software.
A total of 25 literatures were incorporated, encompassing 5 intervention measures, with a sample size of 2,446 cases. The results indicated that in the pairwise meta-analysis, when the MoCA score was used as the outcome indicator, cognitive training [MD = 2.3, 95% CI (1.64, 2.96), P < 0.01], exercise therapy [MD = 2.11, 95% CI (1.30, 2.92), P < 0.01], TCM therapy [MD = 2.28, 95% CI (0.76, 3.81), P < 0.01], and comprehensive intervention [MD = 1.98, 95% CI (1.53, 2.48), P < 0.01] were more effective in improving the cognitive status of patients than the control group; when the MMSE was used as the outcome indicator, cognitive training [MD = 2.03 95% CI (1.57, 2.49), P < 0.01], exercise therapy [MD = 2.78, 95% CI (1.48, 4.08), P < 0.01], and TCM therapy [MD = 2.09, 95% CI (1.46, 2.73), P < 0.01] were more effective in improving the cognitive status of patients than the control group. The SUCRA ranking revealed that in terms of improving the MoCA scores, the comprehensive intervention (SUCRA 76.9%), cognitive training (SUCRA 63.3%), and TCM therapy (SUCRA 57.9%) were the top 3 preferred treatment measures; for improving the MMSE scores, exercise therapy (SUCRA 78.0%) and cognitive training (SUCRA 73.8%) were the preferred treatment measures.
The current evidence indicates that cognitive training, exercise therapy, and TCM therapy might be relatively effective intervention approaches for improving the cognitive function of patients with type 2 diabetes mellitus (T2DM) accompanied by mild cognitive impairment (MCI), and cognitive training could potentially be the most efficacious non-pharmacological treatment method. Constrained by the quantity and quality of the studies, more high-quality research is still required in the future to further validate this conclusion.
非药物干预是2型糖尿病合并轻度认知障碍患者认知功能干预管理的重要治疗方式。然而，哪种干预措施最有效仍不明确。本研究的目的是比较并排序各种非药物干预对2型糖尿病合并轻度认知障碍患者认知功能的影响。
检索从数据库建立至2024年11月的8个数据库。使用RoB2.0工具评估文献质量。使用Stata/SE 15.1软件进行配对Meta分析，使用R 4.3.1软件进行网状Meta分析。
共纳入25篇文献，涵盖5种干预措施，样本量为2446例。结果表明，在配对Meta分析中，以MoCA评分作为结局指标时，认知训练[MD = 2.3，95%CI(1.64, 2.96)，P < 0.01]、运动疗法[MD = 2.11，95%CI(1.30, 2.92)，P < 0.01]、中医治疗[MD = 2.28，95%CI(0.76, 3.81)，P < 0.01]和综合干预[MD = 1.98，95%CI(1.53, 2.48)，P < 0.01]在改善患者认知状态方面比对照组更有效；以MMSE作为结局指标时，认知训练[MD = 2.03，95%CI(1.57, 2.49)，P < 0.01]、运动疗法[MD = 2.78，95%CI(1.48, 4.08)，P < 0.01]和中医治疗[MD = 2.09，95%CI(1.46, 2.73)，P < 0.01]在改善患者认知状态方面比对照组更有效。SUCRA排序显示，在改善MoCA评分方面，综合干预(SUCRA 76.9%)、认知训练(SUCRA 63.3%)和中医治疗(SUCRA 57.9%)是前3种首选治疗措施；在改善MMSE评分方面，运动疗法(SUCRA 78.0%)和认知训练(SUCRA 73.8%)是首选治疗措施。
目前的证据表明，认知训练、运动疗法和中医治疗可能是改善2型糖尿病(T2DM)合并轻度认知障碍(MCI)患者认知功能的相对有效的干预方法，认知训练可能是最有效的非药物治疗方法。受研究数量和质量的限制，未来仍需要更多高质量的研究来进一步验证这一结论。
