摘要
目的对针灸干预轻度认知障碍(Mild cognitive impairment,MCI)的临床研究进行概括性评价,全面明确该领域的研究现状,以期为今后针灸干预MCI的重点临床研究方向及临床决策提供参考。方法在中国知网、万方、维普、中国生物医学数据库、Pubmed、Web of Science、Embase、Cochrane library等数据库及WHO ICTRP、Clinical Trials等实验注册平台进行系统检索,收集针灸干预MCI的临床原始研究、系统评价(Systematic reviews,SRs)和(或)Meta分析(Meta analyses,MAs),语言限制为中英文,检索时间为建库至2022年7月27日。对纳入文献从年度发表趋势、中医辨证分型、针灸干预方案、结局指标等方面进行总结,同时借助AMASTAR 2对SRs/MAs进行方法学质量评估,使用气泡图等构建证据图谱。结果最终纳入临床原始研究108篇、SRs/MAs 9篇。纳入的临床原始研究均为随机对照研究;2006-2022年文献发表量大体呈上升趋势;中医辨证分型纷繁复杂,以肾精亏虚证居多(占25.25%);特殊针灸干预方案作为干预措施最为常见;结局指标以简易精神状态量表、蒙特利尔认知评估量表、日常生活活动能力等为主。AMSTAR 2评价结果显示纳入SRs/MAs均存在至少2项关键条目不符合的情况,方法学质量等级均评为极低。结论当前针灸干预MCI发展前景良好,值得深入研究,但仍存在临床研究类型单一、中医辨证缺乏统一标准、结局指标报告仍需进一步规范等问题。此外,现有SRs/MAs证据质量普遍不高,针灸干预MCI临床有效性、安全性等尚需更深入的研究以明确。
Objective A scoping review of clinical research studies on acupuncture and moxibustion intervention in mild cognitive impairment(MCI),to get a comprehensive understanding of the current state of research in the field,in order to provide reference for the key research direction and clinical decision-making of acupuncture and moxibustion intervention in MCI in the future.Methods Systematic searches were carried out in Chinese and English databases(such as CNKI,Wanfang,VIP,China Biomedical Database,Pubmed,Web of Science,Embase,The Cochrane library),and trial registration platforms(such as WHO ICTRP and Clinical Trials.gov).the clinical studies and Systematic Reviews(SRs)and/or Meta-analyses(MAs)of acupuncture and moxibustion in the treatment of MCI were collected.The search language is limited to Chinese and English,and the search time is from the establishment to July 27,2022.The final included studies were summarized from the aspects of annual publication trend,the patterns of Traditional Chinese medicine(TCM)syndrome differentiation,acupuncture treatment plan,and outcome indicators of clinical studies.AMASTAR 2 was used to evaluate the methodological quality of SRs/MAs,and evidence mapping was constructed using bubble charts,etc.Results 108 original clinical studies and 9 SRs/MAs were included.The included clinical studies were randomized controlled trials.From 2006 to 2022,the number of publications generally showed an upward trend.Kidney essence deficiency syndrome was the most common dialectical classification in TCM.Special acupuncture treatment regimens are most common as interventions.And outcome measures were mainly Mini-Mental State Examination,Montreal Cognitive Assessment,and Activities of Daily Living,and so on.The assessment of AMSTAR 2 showed at least more than 2 critical flaws,the methodological quality of included SRs/MAs was critically low.Conclusion At present,acupuncture and moxibustion intervention for MCI has a good development prospect and is worthy of in-depth study,but there are still problems such as a single type of clinical study,lack of unified standards for TCM syndrome differentiation,and further standardization of outcome indicator reporting.In addition,the quality of existing evidence for SRs/MAs is generally low,and more in-depth studies are needed to clarify the clinical efficacy and safety of acupuncture and moxibustion intervention for MCI.
作者
陈正红
银子涵
李雅琴
夏嫚泽
张欣悦
梁繁荣
Chen Zhenghong;Yin Zihan;Li Yaqin;Xia Manze;Zhang Xinyue;Liang Fanrong(School of Acupuncture-Moxibustion and Tuina,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Acupuncture Clinical Medicine Research Center of Sichuan Province,Chengdu 611138,China;Hospital of University of Tibetan Medicine,Lhasa 850000,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2023年第10期3420-3430,共11页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家中医药管理局-基于经穴效应临床基础重点研究室研究领域的中医临床疗效提升项目,负责人:梁繁荣
关键词
针灸
轻度认知障碍
概括性评价
系统评价
临床原始研究
Acupuncture therapy
Mild cognitive impairment
Scoping review
Systematic reviews Clinical original studies
作者简介
通讯作者:梁繁荣,本刊编委,教授,博士研究生导师,主要研究方向:穴位敏化及经穴特异性。
