中医药研究论丛

243.1 Acupoints Stimulation for Alzheimer’s Disease and Mild Cognitive Impairment: A Meta-Analysis
TJ TCM.24(3) : 1-28, 2021
穴位刺激治疗阿兹海默氏症和轻度认知障碍:统合分析一例
Acupoints Stimulation for Alzheimer’s Disease and Mild Cognitive Impairment: A Meta-Analysis
萧坤元1,2 陈欣进3,4 陈俞沛5,6* 谢淑兰2,4,7,8*
1 奇美医学中心中医部,台南,台湾
2 成功大学健康照护研究所,台南,台湾
3 中正大学心理系,嘉义,台湾
4 中正大学高龄跨域创新研究中心,嘉义,台湾
5 卫生福利部台南医院中医科,台南,台湾
6 成功大学医学系,台南,台湾
7 成功大学心理系,台南,台湾
8 成功大学公共卫生学系,台南,台湾
【摘要】
目的:阿兹海默氏症(AD)和轻度认知障碍(MCI)与衰老相关,已成为人们关注的主要健康问题。全世界的人口老化让这个议题更为突出。AD 和MCI 的治疗方式不只有药物,一些非药物疗法已在发展,例如穴位刺激和针灸。本研究的目的是评估穴位刺激改善AD 或MCI 患者认知功能的临床疗效。
方法:我们在10 个数据库中搜索研究报告。必须满足以下条件:(1)患有AD 或MCI 的老年人;(2)实验组接受穴位刺激;(3)接受对照治疗,假治疗或任何药物治疗的对照组。搜寻到的认知评估结果将汇总并整合到我们的分析中。此外,我们使用Jadad’s score 进行各研究报告的品质评估。迷你精神状态检查(MMSE)是在研究中最常用的认知功能指标。
结果:我们基於MMSE 的统合分析结果显示,穴位刺激的效果优於药物和对照组。此外,基於标准化指标整合的结果显示出相似的结果。在标准化的认知指标的分析中,发表性偏误很显着,但在MMSE 中没有,但是,Fails-Safe N 的测试显示,发表性偏误对统合分析的结果影响很小。
结论:根据本研究,穴位刺激在改善AD 或MCI 的认知功能优於药物治疗和对照治疗。这说明针刺治疗可能是一项可行的选择。
【关键词】衰弱症、中医证型
 
Kun-Yuan Hsiao1,2 Hsin-Chin Chen3,4 Yu-Pei Chen5,6* Shulan Hsieh2,4,7,8*
1Department of Traditional Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan
2Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
3Department of Psychology, National Chung Cheng University, Chiayi, Taiwan
4Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Taiwan
5Department of Traditional Chinese Medicine, Tainan Hospital, Ministry of Health and
Welfare, Tainan, Taiwan
6Department of Medicine, National Cheng Kung University, Tainan, Taiwan
7Department of Psychology, National Cheng Kung University, Tainan, Taiwan
8Department and Institute of Public Health, National Cheng Kung University, Tainan, Taiwan
【Summary】
Objective: Alzheimer’s disease (AD) and mild cognitive impairment (MCI) are associated with aging and have become major health concerns. In addition, population aging is prominent worldwide. Medication is not the only method of treating AD and MCI; some nonmedication treatments have been under development, such as acupoint stimulation and acupuncture. The purpose of the current study was to evaluate the clinical efficacy of acupoint stimulation for improving cognitive function in patients with AD or MCI.
Methods: We searched for articles in 10 databases. The articles had to satisfy the following conditions: (1) elderly patients with AD or MCI; (2) an experimental group that received acupoint stimulation; and (3) a comparison group that received a control treatment, sham treatment, or any medication. The cognitive evaluation results were aggregated and integrated into our analysis. Moreover,the methodologies in the articles were assessed using Jadad scoring. The Mini-Mental State Examination (MMSE) was the most commonly used indicator in the  identified studies for assessing cognitive function.
Results: The results of our meta-analysis based on the MMSE indicated that the effect of acupoint stimulation was superior to those of drug and control treatments. Furthermore, the results based on the integration of standardized indicators showed similar outcomes. Publication bias was significant in the analysis of standardized indicators but not of the MMSE, however, the tests of Fail-safe N suggested that the publication bias may have had little effect on the results of the meta-analysis.
Conclusion: According to this study, acupoint stimulation had superior efficacy compared with drug therapy and control treatment for improving cognitive function in patients with AD or MCI. This demonstrated that acupuncture stimulation may be a viable option for treatment.
 
【Keywords】Acupuncture; Alzheimer’s Disease; Mild Cognitive Impairment;
Meta-Analysis