Différences
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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:neuro-psychiatrie:14. maladie d alzheimer [21 Mar 2025 15:22] Nguyen Johan [1.2.3.1. Chen 2022] |
acupuncture:evaluation:neuro-psychiatrie:14. maladie d alzheimer [15 Jun 2025 07:04] (Version actuelle) Nguyen Johan [1.1.1. Wu 2025] |
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| ===== 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 ==== | ||
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| - | === Wu 2025 === | + | === Wu J 2025 === |
| 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 | 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 | ||
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| ^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. | | ^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.| | ^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.| | ||
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| + | === Wu Y 2025 (combined with donepezil) === | ||
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| + | 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.| | ||
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| + | === Guo 2024 (cognitive impairment) === | ||
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| + | 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.| | ||
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