摘要
目的评价活血法联合针刺治疗血管性认知障碍(VCI)的临床效果。方法以主题词“活血”“化瘀”“通络”“针刺”“血管性认知障碍”“血管性痴呆”“中风后痴呆”检索中国生物医学文献服务系统(CBM)、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)、PubMed、Web of Science从建库至2019年11月公开发表的随机对照试验研究(RCT),筛选符合纳入标准的文献,运用RevMan 5.3软件行Meta分析。结果纳入13个RCT,共1150例患者,结果显示活血法方药联合针刺治疗可以明显提高VCI患者的临床疗效[OR=3.65,95%CI(2.49,5.35),P<0.00001],改善简易精神状态检查量表评分[MD=3.49,95%CI(2.18,4.80),P<0.00001]、蒙特利尔认知评估量表评分[MD=1.73,95%CI(0.78,2.69),P=0.0004],明显降低美国国立卫生研究院卒中量表评分[MD=-3.36,95%CI(-4.25,-2.47),P<0.00001]和全血黏度[MD=-0.78,95%CI(-1.04,-0.53),P<0.00001]。结论在常规西药治疗的基础上加用活血化瘀方药联合针刺治疗VCI在改善认知功能障碍、恢复缺损的神经功能和降低全血黏度方面显著优于纯西医治疗。
Objective To systematically evaluate the effect of blood activating therapy combined with acupuncture in the treatment of vassular cognitive impairment(VCI).Methods Based on the key words of“promoting blood circulation”,“removing blood stasis”,“dredging collaterals”,“acupuncture”,“vascular cognitive impairment”,“vascular dementia”and“post stroke dementia”,this study searched CBM,CNKI,Wanfang Data,VIP,PubMed and Web of Science from the establishment of the database to November 2019.Randomized controlled trials(RCTs)published in these database were studied.Meta-analysis was performed by RevMan 5.3 software.Results Thirteen trials involving 1150 patients were included.The meta-analysis results showed that the method of promoting blood circulation combined with acupuncture could improve the curative effects of VCI patients(OR=3.65,95%CI[2.49,5.35],P<0.00001),mini mental status examination scores(MD=3.49,95%CI[2.18,4.80],P<0.00001),Montreal cognitive assessment scores(MD=1.73,95%CI[0.78,2.69],P=0.0004)and reduce the scores of National Institute of Health stroke scale(MD=-3.36,95%CI[-4.25,-2.47],P<0.00001)as well as whole blood viscosity(MD=-0.78,95%CI[-1.04,-0.53],P<0.00001).Conclusion On basis of the conventional Western medicine treatment,combination of promoting blood circulation and acupuncture for VCI is significantly better than using Western medicine alone in improving cognitive dysfunction,restoring defective nerve function and reducing whole blood viscosity.
作者
谭景斐
许秀
张中平
石建
练梦结
TAN Jingfei;XU Xiu;ZHANG Zhongping;SHI Jian;LIAN Mengjie(Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510405,China;Department of Rehabilitation,Clifford Hospital,Guangdong Province,Guangzhou511495,China)
出处
《中国医药导报》
CAS
2020年第26期139-144,共6页
China Medical Herald
基金
广东省中医药局中医药科研项目(20201290)。
关键词
血管性认知障碍
活血
针刺
血管性痴呆
META分析
Vascular cognitive impairment
Promoting blood circulation
Acupuncture
Vascular dementia
Meta-analysis
