Différences
Ci-dessous, les différences entre deux révisions de la page.
| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
|
acupuncture:evaluation:neuro-psychiatrie:14. maladie d alzheimer [28 Dec 2023 15:59] Nguyen Johan [1.2.1. Comparison of acupuncture techniques] |
acupuncture:evaluation:neuro-psychiatrie:14. maladie d alzheimer [15 Jun 2025 07:04] (Version actuelle) Nguyen Johan [1.1.1. Wu 2025] |
||
|---|---|---|---|
| Ligne 8: | Ligne 8: | ||
| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | | ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | | + | |
| - | | ☆☆ | Evidence for effectiveness of acupuncture | | + | |
| - | | ☆ |Limited evidence for effectiveness of acupuncture | | + | |
| - | | Ø |No evidence or insufficient evidence | | + | |
| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
| - | === Wang 2023 === | ||
| - | Wang XS, Li JJ, Wang YS, Yu CC, He C, Huang ZS, Jiang T, Hao Q, Kong LH. Acupuncture and Related Therapies for the Cognitive Function of Alzheimer's Disease: A Network Meta-Analysis. Iran J Public Health. 2021 Dec;50(12):2411-2426. https://doi.org/10.18502/ijph.v50i12.7924 | + | |
| + | |||
| + | |||
| + | === Wu J 2025 === | ||
| - | ^Background| Acupuncture and acupuncture-related therapies are effective for Alzheimer's disease (AD), therefore, we aimed to compare and rank the interventions that mainly focus on acupuncture-related therapies in the treatment of patients with mild to moderate AD.| | + | Wu J, Teng Y, Xie Y, Xing S, Zhi S. Comparing the efficacy of physical therapy interventions in Alzheimer's disease: a network meta-analysis. Front Aging Neurosci. 2025 Mar 5;17:1541287. https://doi.org/10.3389/fnagi.2025.1541287 |
| - | ^Methods| We used network meta-analysis to evaluate the direct and indirect evidence shown in randomized controlled trials of AD. The data were analyzed using RavMan manager, Stata, and WinBUGS software after two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies.| | + | ^Backgroung| Alzheimer's disease (AD) is a progressive and debilitating neurodegenerative disorder that significantly impairs cognitive function and daily living abilities, representing a major public health challenge. Given the multifactorial nature of AD, effective therapeutic interventions targeting both cognitive and functional decline are critical. | |
| - | ^Results|We analyzed a total of 36 eligible studies, including 2712 patients, involving 14 types of acupuncture-related therapies and comprehensive therapies. For Mini-Mental State Examination (MMSE), acupuncture (ACU) combined with cognitive and memory training (Training) was more effective than ACU, ACU+Chinese herb (CH), ACU+Donepezil (DON), CH, DON, DON+Nimodipine (NIM), Music therapy (Music), NIM, Placebo, and Training (P<0.05), while ACU+CH was batter than CH (P<0.05), and ACU+DON+NIM was better than DON+NIM (P<0.05). For Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog), ACU was more effective than DON and placebo (P<0.05). For Activities of Daily Living (ADL), ACU+DON was better than CH, DON, NIM, and Placebo (P<0.05). For the clinical effectiveness rate, ACU, ACU+CH, ACU+CH+DON, ACU+CH+DON+NIM, ACU+DON, CH, NIM were all more effective than DON+NIM (P<0.05), while ACU and ACU+CH were better than DON (P<0.05). The comprehensive ranking results show that ACU+training and ACU have the highest ranking probability.| | + | ^Methods|This study aimed to conduct a comprehensive comparison of the therapeutic effects of music therapy, acupuncture therapy, game therapy, cognitive training therapy, and exercise therapy on AD patients through a network meta-analysis. Randomized controlled trials (RCTs) published up until 2024 were systematically retrieved from multiple databases. Data were extracted, including the first author, publication year, country, total sample size, mean participant age, type and duration of intervention, and outcome measures such as the Mini-Mental State Examination, Activities of Daily Living, and Alzheimer's Disease Assessment Scale-Cognitive Subscale. Statistical analyses were performed using the RevMan 5.3 and Stata 17 software. The analysis included 52 RCTs with a total of 3,409 participants, offering a strong dataset. | |
| - | ^Conclusion|ACU+Training and ACU may be the best therapies to improve the cognitive function of patients with mild to moderate AD, while the combination of acupuncture-related therapies and other therapies has a higher overall benefit.| | + | ^Results| The results indicated that game therapy produced statistically significant improvements in mental state and daily living abilities, while acupuncture therapy yielded the most pronounced improvements in cognitive function among AD patients. Notably, the comparative efficacy of these interventions suggests that game therapy may offer short-term benefits, particularly for mental health and functional abilities, whereas **acupuncture therapy** demonstrated superior long-term cognitive enhancements. | |
| + | ^Conclusions| In conclusion, tailored physical and cognitive interventions such as game therapy and **acupuncture therapy** may hold significant potential in optimizing treatment outcomes for AD patients, with implications for both clinical practice and future research.| | ||
| + | |||
| + | |||
| + | === Wu Y 2025 (combined with donepezil) === | ||
| + | |||
| + | |||
| + | Wu Y, Zhan Y, Zhu W, Pei J. Effectiveness of acupuncture combined with donepezil for Alzheimer's disease: A systematic review and meta-analysis. Medicine (Baltimore). 2025 Jun 6;104(23):e42651. https://doi.org/10.1097/MD.0000000000042651 | ||
| + | ^Backgound| The incidence of Alzheimer's disease (AD) is gradually increasing in an aging society, imposing a heavy burden on society. Current studies have found that acupuncture therapy combined with donepezil has a good clinical effect in treating AD. We plan to conduct a systematic review and meta-analysis to evaluate the effectiveness of acupuncture combined with donepezil in AD patients.| | ||
| + | ^Methods| Eight databases were searched for randomized controlled trials (RCTs) using acupuncture in combination with donepezil for the treatment of AD, from the establishment of the database to October 1st, 2023. The clinical efficacy rate, Mini-Mental State Examination, AD Assessment Scale for Cognitive Capacity, Skill Level on Activities of Daily Living, Montreal Cognitive Assessment, Behavioral Pathology in AD Rating Scale, and adverse events were mainly used to evaluate the outcomes. RevMan 5.4.1 software was used to evaluate the quality of the included studies and perform a meta-analysis.| | ||
| + | ^Results| A total of **12 RCTs** were included. Meta-analysis showed that acupuncture combined with donepezil seemed to be more effective than donepezil monotherapy for treatment of AD in improving the clinical efficacy rate (relative risk = 1.35; 95% confidence interval [CI]: 1.17-1.56; Z = 4.10; P < .0001), the Mini-Mental State Examination score (mean difference [MD] = 3.28; 95% CI: 1.81-4.75; Z = 4.37; P < .0001), and the Montreal Cognitive Assessment score (MD = 6.04; 95% CI: 4.76-7.32; Z = 9.23; P = .00001), while reducing the AD Assessment Scale for Cognitive Capacity score (MD = -3.57; 95% CI: -3.94 to -3.20; Z = 18.91; P < .00001), the Skill Level on Activities of Daily Living score (MD = -2.52; 95% CI: -4.05 to -0.99; Z = 3.23; P = .001), and the Behavioral Pathology in AD Rating Scale score (MD = -4.04; 95% CI: -4.58 to -3.50; Z = 14.64; P < .00001).| | ||
| + | ^Conclusions| Acupuncture combined with donepezil is an effective treatment which can improve cognitive ability and quality of life for AD patients. However, it is imperative to conduct more large-scale and high-quality RCTs in order to establish more definitive conclusions regarding this therapeutic approach in the future.| | ||
| + | |||
| + | |||
| + | |||
| + | === Guo 2024 (cognitive impairment) === | ||
| + | |||
| + | Guo R, Shen X, Ealing J, Zhou J, Lu J, Ning Y. Efficacy and safety of acupuncture for cognitive impairment in Alzheimer's disease: a systematic review and meta-analysis. Front Dement. 2024 Jul 3;3:1380221. https://doi.org/10.3389/frdem.2024.1380221 | ||
| + | ^Objective| To systematically evaluate the efficacy of acupuncture in the treatment of cognitive impairment in Alzheimer's disease (AD) by meta-analysis, in order to provide evidence-based evidence for the application of acupuncture therapy in the clinical process of AD.| | ||
| + | ^Methods| From the establishment of the database to December 31, 2022, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), VIP database, WanFang Database, Pubmed, Embase and Cochrane Library Database were systematically searched. To collect published randomized controlled clinical trials (RCTS) of acupuncture in the treatment of cognitive impairment in AD. The subjects in the intervention group were given acupuncture alone or combined with other treatments the same as the control group; the control group received conventional Western medicine treatment. The main outcome indicators of the study were cognitive function assessment of subjects, including: Simple Mental State Examination Scale (MMSE), Assessment of daily Living Ability Scale (ADL), Alzheimer's Disease Cognitive Function Assessment Scale (ADAS-Cog), TCM syndrome score (SDSD), Montreal Cognitive Test (MoCA), Secondary outcome indicators were the occurrence of adverse reactions. Literature screening, data extraction, and quality evaluation of the included literature were performed independently by two researchers, according to bias risk assessment tools recommended in the Cochrane manual. Data were analyzed by RevMan5.3 software. Dichotomous variables were represented by risk ratio (OR) and 95% CI, and continuity variables were represented by mean difference (MD) and 95% CI. For heterogeneity analysis, when P > 0.1 and I 2 ≤ 50%, fixed effect model was applied. When P ≤ 0.1 and I 2 > 50%, the random effects model is applied.| | ||
| + | ^Results| A total of **1,172 eligible subjects were included in 18 RCTS**, including 595 in the intervention group and 577 in the control group. The results of meta-analysis are as follows: acupuncture intervention group improved MMSE [MD = 1.67, 95% CI (0.94, 2.41), P < 0.00001], ADL [MD = -1.18, 95% CI (-3.09, 0.72), P = 0.22], ADAS-Cog [MD = 3.31, 95% CI (5.84, 0.78), P = 0.01], SDSD [MD = 2.40, 95% CI (3.53, 1.26), P < 0.0001], MoCA [MD = 4.80, 95% CI (3.74, 5.86), P = 0.04] were better than the control group. No serious adverse reactions related to acupuncture were observed in the intervention group, and the incidence and severity of adverse reactions were lower than those in the control group, with statistical significance [OR = 0.17, 95% CI (0.04, 0.67), P = 0.01].| | ||
| + | ^Conclusion| Existing data show that acupuncture therapy has certain advantages in improving cognitive dysfunction and improving self-care ability of patients with Alzheimer's disease. However, due to the small number of RCTS and cases evaluating the efficacy of acupuncture, and the possibility of measurement bias and selectivity bias in included studies, it is still unable to conduct high-intensity demonstration on its effectiveness. Further large-scale, high-quality randomized, double-blind controlled trials are needed to evaluate its efficacy.| | ||
| + | |||
| + | |||
| === Lin 2022 === | === Lin 2022 === | ||
| Ligne 36: | Ligne 59: | ||
| ^Conclusion|Acupuncture-related treatments effectively improved cognitive function with the treatment lasted 6 weeks at least, but self-care ability started showing effects after 12 weeks of treatment. The improvement of muscle strength was also confirmed. Acupuncture-related treatments, particularly noninvasive ones, have few complications and high safety, perhaps providing patients and caregivers diversified choices and clinical care guidelines for reference.| | ^Conclusion|Acupuncture-related treatments effectively improved cognitive function with the treatment lasted 6 weeks at least, but self-care ability started showing effects after 12 weeks of treatment. The improvement of muscle strength was also confirmed. Acupuncture-related treatments, particularly noninvasive ones, have few complications and high safety, perhaps providing patients and caregivers diversified choices and clinical care guidelines for reference.| | ||
| + | |||
| + | === Wang 2021 (Network Meta-Analysis)=== | ||
| + | |||
| + | Wang XS, Li JJ, Wang YS, Yu CC, He C, Huang ZS, Jiang T, Hao Q, Kong LH. Acupuncture and Related Therapies for the Cognitive Function of Alzheimer's Disease: A Network Meta-Analysis. Iran J Public Health. 2021 Dec;50(12):2411-2426. https://doi.org/10.18502/ijph.v50i12.7924 | ||
| + | |||
| + | ^Background| Acupuncture and acupuncture-related therapies are effective for Alzheimer's disease (AD), therefore, we aimed to compare and rank the interventions that mainly focus on acupuncture-related therapies in the treatment of patients with mild to moderate AD.| | ||
| + | ^Methods| We used network meta-analysis to evaluate the direct and indirect evidence shown in randomized controlled trials of AD. The data were analyzed using RavMan manager, Stata, and WinBUGS software after two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies.| | ||
| + | ^Results|We analyzed a total of 36 eligible studies, including 2712 patients, involving 14 types of acupuncture-related therapies and comprehensive therapies. For Mini-Mental State Examination (MMSE), acupuncture (ACU) combined with cognitive and memory training (Training) was more effective than ACU, ACU+Chinese herb (CH), ACU+Donepezil (DON), CH, DON, DON+Nimodipine (NIM), Music therapy (Music), NIM, Placebo, and Training (P<0.05), while ACU+CH was batter than CH (P<0.05), and ACU+DON+NIM was better than DON+NIM (P<0.05). For Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog), ACU was more effective than DON and placebo (P<0.05). For Activities of Daily Living (ADL), ACU+DON was better than CH, DON, NIM, and Placebo (P<0.05). For the clinical effectiveness rate, ACU, ACU+CH, ACU+CH+DON, ACU+CH+DON+NIM, ACU+DON, CH, NIM were all more effective than DON+NIM (P<0.05), while ACU and ACU+CH were better than DON (P<0.05). The comprehensive ranking results show that ACU+training and ACU have the highest ranking probability.| | ||
| + | ^Conclusion|ACU+Training and ACU may be the best therapies to improve the cognitive function of patients with mild to moderate AD, while the combination of acupuncture-related therapies and other therapies has a higher overall benefit.| | ||
| === Jiao 2020 === | === Jiao 2020 === | ||
| Ligne 168: | Ligne 200: | ||
| Wang XC, Chu CL, Lu K, Chen X, Jin XQ, Quan SJ. The role of tonifying kidney decoction and acupuncture in the treatment of Alzheimer's disease: A network meta-analysis. Medicine (Baltimore). 2022 Nov 18;101(46):e31243. https://doi.org/10.1097/MD.0000000000031243. | Wang XC, Chu CL, Lu K, Chen X, Jin XQ, Quan SJ. The role of tonifying kidney decoction and acupuncture in the treatment of Alzheimer's disease: A network meta-analysis. Medicine (Baltimore). 2022 Nov 18;101(46):e31243. https://doi.org/10.1097/MD.0000000000031243. | ||
| - | | Importance: As one of the chronic neurological degenerative diseases with the highest incidence of amnesia and dementia, Alzheimer's disease (AD) carried out the clinical treatment based on the 2 traditional Chinese medicine (TCM) of Chinese herbal compound and acupuncture (AP). With the vigorous development of TCM, doctors are facing the problem of choosing TCM or western medicine in clinical work. Hence there is an urge to make pairwise comparisons among these interventions to provide evidence for clinical practice.| | + | ^Importance| As one of the chronic neurological degenerative diseases with the highest incidence of amnesia and dementia, Alzheimer's disease (AD) carried out the clinical treatment based on the 2 traditional Chinese medicine (TCM) of Chinese herbal compound and acupuncture (AP). With the vigorous development of TCM, doctors are facing the problem of choosing TCM or western medicine in clinical work. Hence there is an urge to make pairwise comparisons among these interventions to provide evidence for clinical practice.| |
| ^Objective| The used efficacy of the 2 TCM methods and combined with donepeziline were compared to compile the best treatment through network meta-analysis.| | ^Objective| The used efficacy of the 2 TCM methods and combined with donepeziline were compared to compile the best treatment through network meta-analysis.| | ||
| ^Methods|Patients diagnosed with AD were included in the randomized clinical trial, who were treated with tonifying kidney decoction (TKD) or AP combined with donepezil hydrochloride (DH) as an intervention measure, while the control group was treated with DH. The total effective rate was the primary outcome, and mini-mental state examination (MMSE) score and activities of daily living (ADCS-ADL) scores were the secondary indicators.| | ^Methods|Patients diagnosed with AD were included in the randomized clinical trial, who were treated with tonifying kidney decoction (TKD) or AP combined with donepezil hydrochloride (DH) as an intervention measure, while the control group was treated with DH. The total effective rate was the primary outcome, and mini-mental state examination (MMSE) score and activities of daily living (ADCS-ADL) scores were the secondary indicators.| | ||
| Ligne 216: | Ligne 248: | ||
| ^Results|**8 RCTs comprising 524 patients** were included. Most studies had no significant bias. The study showed that WNM was more effective in the treatment of AD than acupuncture or pharmacotherapy. The findings were as follows: MMSE (MD = 1.01, 95%CI: 0.13, 1.90, P = 0.03) and CDR (MD = -0.73, 95%CI: -0.84, -0.61, P < 0.00001) for global cognitive function, ADL (MD = -1.84, 95%CI: -2.47, -1.22, P < 0.00001) for activities of daily living, Syndrome Differentiation Scale of Dementia (SDSD) (MD = -2.67, 95%CI: -3.62, -1.72, P < 0.00001), and the total effective rate of patients (OR = 3.20, 95%CI: 1.90 to 5.38, P < 0.0001). The differences in all indicators were statistically significant.| | ^Results|**8 RCTs comprising 524 patients** were included. Most studies had no significant bias. The study showed that WNM was more effective in the treatment of AD than acupuncture or pharmacotherapy. The findings were as follows: MMSE (MD = 1.01, 95%CI: 0.13, 1.90, P = 0.03) and CDR (MD = -0.73, 95%CI: -0.84, -0.61, P < 0.00001) for global cognitive function, ADL (MD = -1.84, 95%CI: -2.47, -1.22, P < 0.00001) for activities of daily living, Syndrome Differentiation Scale of Dementia (SDSD) (MD = -2.67, 95%CI: -3.62, -1.72, P < 0.00001), and the total effective rate of patients (OR = 3.20, 95%CI: 1.90 to 5.38, P < 0.0001). The differences in all indicators were statistically significant.| | ||
| ^Conclusion| WNM might have a significant effect on improving cognitive function and daily living ability, reducing the symptoms of AD, and increase the total effective rate. WNM is an effective non-pharmacological therapy for patients with AD.| | ^Conclusion| WNM might have a significant effect on improving cognitive function and daily living ability, reducing the symptoms of AD, and increase the total effective rate. WNM is an effective non-pharmacological therapy for patients with AD.| | ||
| + | |||
| + | ===== Overviews of systematic reviews ===== | ||
| + | |||
| + | ==== Ke 2024 ==== | ||
| + | |||
| + | |||
| + | Ke C, Shan S, Yu J, Wei X, Pan J, Zhang W. Acupuncture for patients with Alzheimer's disease: An evidence map of randomized controlled trials, systematic reviews, and meta-analysis. J Alzheimers Dis. 2024 Dec;102(4):924-942. https://doi.org/10.1177/13872877241295400 | ||
| + | ^Backgound| Acupuncture is an effective complementary treatment for Alzheimer's disease (AD). This review aims to summarize the available evidence provided by randomized controlled trials (RCTs) and systematic reviews (SRs) or meta-analyses (MAs) on the effect of acupuncture on AD. | | ||
| + | ^Objective| To systematically summarize and combine clinical research evidence on AD distribution. | | ||
| + | ^Methods| We conducted a comprehensive search of various databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data, Chinese BioMedical Literature Database (CBM) and Chonqing VIP (CQVIP), from their inception to September 2023. Relevant literature about acupuncture for AD was included, and the characteristics of the evidence map were presented through charts and textual analyses. | | ||
| + | ^Results| In total, **117 RCTs and 17 SRs or MAs** were included. The results were divided into three categories: basic characteristics of the included literature, clinical characteristics and quality assessment of the included RCTs, and clinical characteristics and quality assessment of the included SRs and MAs. | | ||
| + | ^Conclusions| Acupuncture as a therapeutic measure for AD has some advantages in improving cognition and quality of life; thus, it is imperative to conduct multi-center, large-scale RCTs to enhance the evidence supporting the use of acupuncture in AD. This is the first evidence map exploring acupuncture treatment for AD, providing insights into the current clinical research landscape on acupuncture treatment for AD. Furthermore, the findings of this study highlight research gaps in this field and serve as a valuable reference for guiding the planning and selection of topics for future research.| | ||
