摘要
目的系统评价针刺配合药物对于阿尔茨海默病(Alzheimer’s disease,AD)患者认知功能与生活质量的影响。方法计算机检索中国知网数据库(CNKI)、维普数据库(VIP)、万方数据库(Wangfang)、中国生物医学文献数据库(CBM),以及PubMed、Medline、Springer Link、Cochrane Library数据库中有关针刺配合药物治疗阿尔茨海默病的随机对照试验(randomized controlled trials,RCTs),采用Cochrane系统评价方法对纳入的研究进行质量评价,采用Rev Man 5.3软件进行Meta分析。结果共纳入8项研究,涉及472例患者。Meta分析结果显示,治疗组在改善患者简易精神状态量表(MMSE)评分(MD=0.76,95%CI [0.42,1.10],P<0.000 01)、阿尔茨海默病评价量表-认知分量表(ADAS-cog)评分(MD=-0.32,95%CI [-0.61,-0.03],P=0.03)、日常生活能力量表(ADL)评分(MD=-0.66,95%CI [-1.06,-0.27],P=0.001)方面优于对照组。结论针刺配合药物在改善阿尔茨海默病患者认知功能与生活质量方面具有一定的优势,但纳入研究的证据存在偏倚风险及临床异质性,所以有关结论仍有待高质量的研究进一步验证。
Objective To systematically evaluate the efficacy and safety of acupuncture combined with medicine for cognitive functions and life quality of the patients with Alzheimer’s Disease(AD).Methods The randomized controlled trials(RCTs)regarding acupuncture combined with medicine for AD published from January 1 stof 2008 to August 31th of 2018 were researched in China National Knowledge Infrastructure,VIP medicine information system,Wan Fang database,Chinese Biomedical Database,PubMed,Medline,Springer Link and Cochrane Library.The quality assessment was performed based on the guidance of the Cochrane Reviewers’Handbook,and Meta-analyses was performed by using Rev Man 5.3 software.Results Totally 8 RCTs were included,involving 472 AD patients.The results of Meta-analyses showed that the treatment group was superior to the control group in improving the mini-mental state examination(MMSE)(MD=0.76,95%CI[0.42,1.10],P<0.000 01),Alzheimer’s disease assessment scale-cognitive section(ADAS-cog)(MD=-0.32,95%CI[-0.61,-0.03],P=0.03),activities of daily living(ADL)(MD=-0.66,95%CI[-1.06,-0.27],P=0.001).Conclusion Acupuncture combined with medicine for cognitive functions and life quality of AD patients is effective.However,the included studies were with risk of bias and with clinical heterogeneity.So more RCTs of high quality are needed to further confirm its efficacy and safety.
作者
王以申
徐佳
傅勤慧
裴建
WANG Yishen;XU Jia;FU Qinhui;PEI Jian(Department of Acupuncture and Moxibustion,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《上海中医药杂志》
2019年第1期19-25,共7页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市科委重点科研项目(18401970500
16401970300)
国家自然科学基金项目(81603697)
上海市卫计委海派中医流派"陆氏针灸"传承研究项目(ZY3-CCCX-1-1007)
关键词
阿尔茨海默病
针刺
认知功能
生活质量
随机对照试验
系统评价
Alzheimer's disease
Acupuncture
cognitive function
life quality
randomized controlled trial
systematic review
