Effect of Acupuncture on Cognitive Function in Patients With Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES Brain and Behavior Pub Date : 2024-10-14 DOI:10.1002/brb3.70075

Ziyan Luo, Wenxuan Li, Jieting Jiang, Jie Sun, Mingyue Zhang, Yaqing Zhang, Lu Dong, Kunpeng Li, Caiqin Wu

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Abstract

Aims and objective

To investigate the impact of acupuncture on post-stroke cognitive impairment (PSCI).

Background

PSCI is a major barrier to stroke patients’ rehabilitation, and acupuncture is one of the treatments. However, the benefit of acupuncture on PSCI is unclear.

Design

A meta-analysis and systematic review of randomized controlled trials (RCTs).

Methods

Up to February 1, 2024, databases in PubMed, MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang Data were searched. The risk of bias was investigated using the Cochrane Handbook for systematic reviews of treatments. Random-effect and fix-effect models were used to report the effects.

Results

There were 29 randomized clinical trials with 2477 participants included. The findings demonstrated that the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scores were higher in the acupuncture group than medicine group (mean difference [MD] = 1.74, 95% confidence interval (CI) CI [1.26, 2.23], I² = 59%, p < 0.01). Compared to medicine group, the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score exhibited a significant decrease and demonstrated improvement in the acupuncture group. Statistically significant outcomes were observed in the Barthel Index scores and P300 event-related potential (ERP). According to subgroup analysis, acupuncture was superior to conventional therapy for improving cognitive function in PSCI patients at 4 weeks after treatment.

Conclusion

Acupuncture therapy has shown promise in ameliorating cognitive deficits and enhancing daily functional abilities in individuals diagnosed with PSCI. But future research should focus on the duration and implement large sample, high-quality RCTs.

Relevance to clinical practice

Clinical workers in practical clinical work can select appropriate acupoints according to the actual conditions of patients, as well as confirm the treatment course of PSCI patients, while paying attention to observing and evaluating the therapeutic efficacy of acupuncture, to improve the health outcomes of patients in a patient-centered way.

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针灸对脑卒中后认知功能障碍患者认知功能的影响：系统回顾与元分析

目的探讨针灸对中风后认知障碍（PSCI）的影响。背景 PSCI 是中风患者康复的主要障碍，针灸是治疗方法之一。然而，针灸对 PSCI 的益处尚不明确。设计对随机对照试验（RCT）进行荟萃分析和系统回顾。方法检索截至 2024 年 2 月 1 日的 PubMed、MEDLINE、Scopus、Embase、Web of Science、Cochrane Library、中国国家知识基础设施、VIP 和万方数据等数据库。采用《Cochrane治疗方法系统综述手册》对偏倚风险进行了调查。采用随机效应和固定效应模型来报告效果。结果 29 项随机临床试验共纳入 2477 名参与者。研究结果表明，针灸组的迷你精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）得分高于药物组（平均差[MD] = 1.74，95%置信区间（CI）CI [1.26, 2.23]，I2 = 59%，p <0.01）。与药物组相比，针灸组的卢文斯坦职业治疗认知评估（LOTCA）得分显著下降并有所改善。巴特尔指数（Barthel Index）评分和 P300 事件相关电位（ERP）均有统计学意义。根据亚组分析，在治疗 4 周后，针灸在改善 PSCI 患者认知功能方面优于传统疗法。结论针灸疗法在改善 PSCI 患者的认知功能障碍和提高日常功能能力方面具有良好的前景。但未来的研究应关注疗程的长短，并实施大样本、高质量的 RCT。与临床实践的相关性临床工作者在实际临床工作中，可根据患者的实际情况选择合适的穴位，并对 PSCI 患者的疗程进行确认，同时注意观察和评价针灸的疗效，以患者为中心改善患者的健康状况。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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