Acupoints Stimulation for Alzheimer's Disease and Mild Cognitive Impairment: A Meta-Analysis

穴位刺激治療阿茲海默氏症和輕度認知障礙：統合分析一例

蕭坤元(Kun-Yuan Hsiao) ； 陳欣進(Hsin-Chin Chen) ； 陳俞沛(Yu-Pei Chen) ； 謝淑蘭(Shulan Hsieh)

《中醫藥研究論叢》 24卷3期 (2021/09) Pp. 1-28

https://doi.org/10.6516/TJTCM.202109_24(3).0001

摘要

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.

關鍵字

Acupuncture ； Alzheimer's Disease ； Mild Cognitive Impairment ； Meta-Analysis

並列摘要

目的：阿茲海默氏症（AD）和輕度認知障礙（MCI）與衰老相關，已成為人們關注的主要健康問題。全世界的人口老化讓這個議題更為突出。AD和MCI的治療方式不只有藥物，一些非藥物療法已在發展，例如穴位刺激和針灸。本研究的目的是評估穴位刺激改善AD或MCI患者認知功能的臨床療效。方法：我們在10 個數據庫中搜索研究報告。必須滿足以下條件：（1）患有AD或MCI的老年人；（2）實驗組接受穴位刺激；（3）接受對照治療，假治療或任何藥物治療的對照組。搜尋到的認知評估結果將匯總並整合到我們的分析中。此外，我們使用Jadad's score進行各研究報告的品質評估。迷你精神狀態檢查（MMSE）是在研究中最常用的認知功能指標。結果：我們基於MMSE的統合分析結果顯示，穴位刺激的效果優於藥物和對照組。此外，基於標準化指標整合的結果顯示出相似的結果。在標準化的認知指標的分析中，發表性偏誤很顯著，但在MMSE中沒有，但是，Fails-Safe N的測試顯示，發表性偏誤對統合分析的結果影響很小。結論：根據本研究，穴位刺激在改善AD或MCI的認知功能優於藥物治療和對照治療。這說明針刺治療可能是一項可行的選擇。

並列關鍵字

衰弱症 ； 中醫證型

參考文獻

Liu, Z. B., Niu, W. M., Yang, X. H., & Niu, X. M. (2008) Clinical study on the effect of “sniffing three needles” on cognitive function in patients with Alzheimer’s disease. Shaanxi Journal of Traditional Chinese Medicine, 29(6), 711-712.

Liu, Z., Wei, W., Bai, L., Dai, R., You, Y., Chen, S., & Tian, J. (2014). Exploring the patterns of acupuncture on mild cognitive impairment patients using regional homogeneity. PloS one, 9(6), e99335.

Luijpen, M. W., Swaab, D. F., Sergeant, J. A., van Dijk, K. R., & Scherder, E. J. (2005). Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment. Behavioural brain research, 158(2), 349-357.

Mao, J. J., Farrar, J. T., Armstrong, K., Donahue, A., Ngo, J., & Bowman, M. A. (2007). De qi: Chinese acupuncture patients’ experiences and beliefs regarding acupuncture needling sensation-an exploratory survey. Acupuncture in Medicine, 25(4), 158-165.

McManus, C. A., Schnyer, R. N., Kong, J., Nguyen, L. T., Nam, B. H., Goldman, R., ... & Kaptchuk, T. J. (2007). Sham acupuncture devices-practical advice for researchers. Acupuncture in Medicine, 25(1-2), 36-40.