Ceci est une ancienne révision du document !
Sommaire
Maladie d'Alzheimer : évaluation de l'acupuncture
| Articles connexes: - acupuncture expérimentale - |
1. Revues systématiques et méta-analyses
1.1. Acupuncture générique
1.1.1. Zou 2016 ∼
Zou Jingfeng, Xie Ke, Guo Peiyan, Dong Xushuai, Zhao Fei. [Meta-analysis of randomized controlled clinical trial about acupuncture in treating Alzheimer's disease]. Gansu Journal of Traditional Chinese Medicine. 2016;1:80-84. [186969].
| Objectives | To systematically assess the differences between traditional acupuncture and western medicine in treating alzheimer's disease. |
|---|---|
| Methods | Randomized controlled trials (RCTs) about acupuncture compared with western medicine in treating alzheimer's disease were chosen by searching PubMed, Embase, Cochrane library, CNKI, VIP and Wanfang, the quality of the literature which met the included standard were assessed and meta-analysis was performed by using RevMan 5. 2 software. |
| Results | Eight articles and 349 patients were included. The results of Meta-analysis showed that the difference had no statistical meaning between both groups, while clinical effects of acupuncture in treating alzheimer's disease [OR=1. 15, 95%CI (0. 69, 1. 91)], MMSE scaling [MD=0. 40, 95%CI (-2. 18, 2. 97)], ADL scaling [MD=0. 60, 95%CI (-0. 54, 1. 74)], HDS scaling [MD=-0. 20, 95%CI (-1. 19, 0. 80)] were equivalent to these indexes of western medicine. |
| Conclusions | The advantages of acupuncture in treating alzheimer's disease compared with western medicine are unsure, more large samples and high quality RCTs are needed to further validate the results. |
1.1.2. Zhou 2015 ☆☆
Zhou J, Peng W, Xu M, Li W, Liu Z. The Effectiveness and Safety of Acupuncture for Patients with Alzheimer Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2015;94(22). [183449].
| Objectives | The use of acupuncture for treating Alzheimer disease (AD) has been increasing in frequency over recent years. As more studies are conducted on the use of acupuncture for treating AD, it is necessary to re-assess the effectiveness and safety of this practice. The objective of this study was to assess the effectiveness and safety of acupuncture for treating AD. |
|---|---|
| Methods | Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, Embase, PsycINFO, Chinese Biomedicine Literature (CBM), Chinese Medical Current Content (CMCC) and China National Knowledge Infrastructure (CNKI) were searched from their inception to June 2014. Randomized controlled trials (RCTs) with AD treated by acupuncture or by acupuncture combined with 1 kind of drugs were included. Two authors extracted data independently. The continuous data were expressed as mean differences (MD) with 95% confidence intervals (Cis). Weighted MD (WMD) was used instead of standardized MD (SMD) when the same scales were used. Adverse reactions related to acupuncture were also investigated. |
| Results | Ten randomized controlled trials with a total of 585 participants were included in the meta-analysis. The combined results of 6 trials showed that acupuncture was better than drugs at improving scores on the Mini Mental State Examination (MMSE) scale (MD 1.05, 95% CI 0.16-1.93). Evidence from the pooled results of 3 trials showed that acupuncture plus donepezil was more effective than donepezil alone at improving the MMSE scale score (MD 2.37, 95% CI 1.53-3.21). Out of 141 clinical trials, 2 trials reported the incidence of adverse reactions related to acupuncture. Seven out of 3416 patients had adverse reactions related to acupuncture during or after treatment; the reactions were described as tolerable and not severe |
| Conclusions | Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating AD in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients' ability to carry out their daily lives. Moreover, acupuncture is safe for treating people with AD |
1.1.3. Cao 2014 Ø
Cao Fei, Pan Xiao-Ling, Li Xuan-Chao, Chen Bao, Jin Yuan, Huang Peng. [Systematic review and meta-analysis on acupuncture for Alzheimer disease in chinese population]. Acta Academiae Medicinae Jiangxi. 2014;9:59-61, 6. [186901].
| Objectives | To assess the therapeutic effect of acupuncture on Alzheimer disease (AD)in Chinese population, and to provide more reliable information for the treatment of AD. |
|---|---|
| Methods | The literature published from January 1979 to December 2013 on the acupuncture for treatment of Alzheimer disease in Chinese population was collected, and the effects of acupuncture on mini-mental state examination (MMSE) and activity of daily living (ADL) were assessed. The meta-analysis was conducted by using RevMan5. 0. |
| Results | A total of 5 randomized controlled trials were identified and all controls were oral medications. In the aspect of cognitive function, the weighted mean difference (WMD)was -0. 61 (- 1. 34, 0. 13). In the aspect of ADL, the WMD was -0. 48 (-0. 72, 0. 76). |
| Conclusions | Compared with oral medications, the acupuncture can not improve the MMSE and ADL scores in patients with AD. Furthermore, the quality of literature is poor. Therefore, more observations are needed to verify the effect of acupuncture on AD. |
1.1.4. Lee 2009
Lee MS, Shin BC, Ernst E. Acupuncture for Alzheimer's disease: a systematic review. Int J Clin Pract. 2009;63(6):874-9. [153322].
| Background | Acupuncture is often used as a treatment for dementia and is claimed to be effective in improving intelligence. |
|---|---|
| Aims | The objective of this review is to assess the clinical evidence for or against acupuncture as a treatment for Alzheimer's disease (AD). |
| methods | We searched the literature using 17 databases from their inception to August 2008, without language restrictions. We included all randomised clinical trials (RCTs) of needle acupuncture to treat human patients suffering from AD. Methodological quality was assessed using the Jadad score. |
| Results | Three RCTs met all inclusion criteria. Two RCTs assessed the effectiveness of acupuncture on cognitive function compared with drug therapy. Their results suggested no significant effect in favour of acupuncture [n = 72, weight mean difference (WMDs), -0.55; 95% confidence intervals (CIs) -1.31 to 0.21, p = 0.15, heterogeneity: tau(2) = 0, chi(2) = 0.048, p = 0.49, I(2) = 0%]. Two RCTs tested acupuncture for activities of daily living (ADL). One RCT reported favourable effects of drug therapy compared with acupuncture for ADL, while the other failed to so. The meta-analysis of these data showed significant effects of drug therapy compared with acupuncture (n = 72, WMD, -1.29; 95% CIs: -1.77 to -0.80, p < 0.001, heterogeneity: tau(2) = 0, chi(2) = 0.17, p = 0.68, I(2) = 0%). |
| Conclusion | Even though the number of studies is small, the existing evidence does not demonstrate the effectiveness of acupuncture for AD. |
1.2. Techniques particulières
1.2.1. Zou 2016 (association à la pharmacopée chinoise) ☆
Zou Jingfeng, Guo Peiyan, Xie Ke, Dong Xushuai, Zhao Fei. [Meta-analysis of the effectiveness of acupuncture treatment combined with traditional chinese medicine treatment of Alzheimer disease]. China Journal of Chinese Medicine. 2016;1:138-143. [186905].
目的: 比较针刺联合中药与单用中药治疗阿尔茨海默病的疗效差异. 方法: 通过检索PubMed、Embase、CNKI等中外论文数据库, 筛选出针药对照单用中药治疗阿尔茨海默病的随机临床对照试验. 对符合标准的文献评价质量, 并应用RevMan Manager 5. 2软件进行Meta分析. 结果: 纳入共包括335例患者的6篇文献. Meta分析结果显示, 针药结合、单用中药治疗阿尔茨海默病后的有效率分别为76. 96％和65. 28％, 合并效应量的比值比OR=1. 89, (95％ CI=1. 11, 3. 21), P=0. 02 ＜0. 05, 提示差异有统计学意义;针药与单用中药治疗阿尔茨海默病后的MMSE、ADL量表评分的分析结果分别为MD=1. 55, (95％CI=0. 98, 2. 12), P＜0. 000 01、WMD=0. 36, (95％ CI=0. 14, 0. 59), P=0. 002, 以上结果P均＜0. 05, 提示治疗前后量表评分改变上针药与单用中药的疗效比较, 差异有统计学意义. 结论: 针药结合比单用中药治疗阿尔茨海默病更具优势, 但仍需更多大样本高质量的随机临床对照试验进一步验证.
| Automatic translation | |
| Objectives | to compare the Alzheimer's disease treated by acupuncture combined with traditional Chinese medicine and traditional Chinese medicine efficacy. |
|---|---|
| Methods | Search PubMed, Embase, CNKI database and foreign papers, filter out acupuncture controlled randomized controlled clinical trials of traditional Chinese medicine for treatment of Alzheimer's disease alone. To meet the standard of quality of literature evaluation, and using RevMan Manager 5. 2 software Meta analysis. |
| Results | included in total including 335 cases 6 references. Meta analysis shows that acupuncture and using traditional Chinese medicine for treatment of Alzheimer's disease, the effective rate was 76. 96% and 65. 28%, the combined effect of the ratio of OR=1. 89, (95% CI=1. 11, 3. 21), P=0. 02 <0. 05, indicating there was a statistically significant difference; acupuncture and using traditional Chinese medicine in the treatment of Alzheimer's disease after the MMSE, ADL scale scores results for MD=1. 55, (95%CI=0. 98, 2. 12), P<0. 000 01、WMD=0. 36, (95% CI=0. 14, 0. 59), P=0. 002, results above all <0. 05, scores on the changes before and after treatment of acupuncture and medicine with comparison of the curative effect of traditional Chinese medicine alone, there was a statistically significant difference. |
| Conclusions | acupuncture has an advantage over using traditional Chinese medicine in the treatment of Alzheimer's disease, but still needs more large scale high quality randomized controlled trials for further verification. |
1.2.2. Xu 2015 (association au traitement médicamenteux) ☆☆
Xu Xiaotai, Xie Wei. [Meta-analysis on acupuncture combined with western medicine for treatment of Alzheimer’s disease]. World Science and Technology-Modernization of Traditional Chinese Medicine. 2015;4:836-840. [187068].
| Objectives | This study was aimed to evaluate efficacy of acupuncture combined with western medicine in treatment of Alzheimer’s disease (AD) with meta-analysis of data came from randomized controlled trials (RCTs). |
|---|---|
| Methods | Databases both at home and abroad were comprehensively searched to collect efficacy data of acupuncture combined with western medicine versus western medicine in RCTs. The data was extracted from each study to conduct a meta-analysis with Rev Man 5. 2. |
| Results | The results showed that 10 studies measured up to standard. Seven studies reported effective cases were carried out by meta-analysis. The total RR was 1. 25 [1. 14, 1. 38]. The funnel plot was approximately symmetry. It was suggested that effect of the therapy group was better than the control group (Z = 4. 66, P<0. 01). Four studies reported mini-mental state examination (MMSE) scores were carried out by meta-analysis. The total MD was 2. 87 [0. 64, 5. 10]. The funnel plot was approximately symmetry. It was suggested that the therapy group was better than the control group on AD treatment in cognitive function improvement (Z = 2. 52, P= 0. 01). |
| Conclusions | It was concluded that from current study, acupuncture combined with western medicine in AD treatment was definitely effective. However, it still required further study. |
