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Sommaire
Alzheimer’s disease: effectiveness of acupuncture
Maladie d'Alzheimer : évaluation de l'acupuncture
| Articles connexes: - acupuncture expérimentale - |
1. Systematic Reviews and Meta-Analysis
| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture |
| ☆☆ | Evidence for effectiveness of acupuncture |
| ☆ | Preuves limitées en faveur d’une efficacité de l’acupuncture |
| Ø | Absence de preuve ou preuves insuffisantes |
1.1. Acupuncture générique
1.1.1. Jiao 2020
Jiao Lan, Ji-fei Miao, Shu-qi Ge, Tie-qu Chai, … Li-ming Lu. Acupuncture for cognitive impairment in vascular dementia, Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis. European Journal of Integrative Medicine. 2020;35. [212068]. doi
| Introduction | Cognitive impairment is a worldwide health problem. Numerous studies have been conducted to evaluate the effect of acupuncture on cognitive impairment. However, it is still unclear that if acupuncture shows the same efficacy on cognitive impairment caused by different diseases. Therefore, we conducted a systematic review and meta-analysis based on the current evidence to evaluate the efficacy and safety of acupuncture for cognitive impairment in vascular dementia (VD), Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients. |
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| Methods | Five databases were searched from their inception to December 2019. Randomized controlled trials (RCTs) involving VD, AD or MCI treated by acupuncture alone or as part of combination therapy were included. The primary outcomes were the Mini-Mental State Examination and the Hierarchic Dementia Scale. |
| Results | Twenty-one RCTs (N = 2253) were quantitatively analyzed. For VD, compared with Western medicine (WM), acupuncture showed better Hierarchic Dementia Scale scores (P < 0.01), and acupuncture plus WM also showed better Hierarchic Dementia Scale scores (P < 0.01). For MCI, acupuncture showed a significant improvement in Mini-Mental State Examination (P < 0.01) and picture recognition test scores compared with WM. For AD, WM resulted in better Hierarchic Dementia Scale scores than acupuncture (P < 0.01). Eight trials reported adverse events, 15 out of 2253 patients had adverse events related to acupuncture treatment, and 25 out of 2253 patients had adverse events related to WM treatment. |
| Conclusion | Acupuncture may be efficacious for improving cognitive function in patients with VD and MCI. However, the evidence is limited, and larger sample size and more rigorous RCTs should be conducted to verify the effectiveness and safety of acupuncture. |
1.1.2. Lai 2020 (Network Meta-Analysis)
Lai X, Wen H, Li Y, Lu L, Tang C. The Comparative Efficacy of Multiple Interventions for Mild Cognitive Impairment in Alzheimer's Disease: A Bayesian Network Meta-Analysis. Front Aging Neurosci. 2020. [210345]. doi
| Background | Mild cognitive impairment (MCI) is the early phase of Alzheimer's disease (AD). The aim of early intervention for MCI is to decrease the rate of conversion from MCI to AD. However, the efficacy of multiple interventions in MCI, and the optimal methods of delivery, remain controversial. We aimed to compare and rank the treatment methods for MCI in AD, in order to find an optimal intervention for MCI and a way to prevent or delay the occurrence of AD. |
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| Methods | Pair-wise and network meta-analysis were conducted to integrate the treatment effectiveness through direct and indirect evidence. Four English databases and three Chinese databases were searched for international registers of eligible published, single or double blind, randomized controlled trials up to September 31st 2019. We included nine comparative interventions: pharmacological therapies which incorporated cholinesterase inhibitors (ChEI), ginkgo, nimodipine, and Chinese medicine; non-pharmacological therapies comprising of acupuncture, music therapy, exercise therapy, and nutrition therapy; and a placebo group. The primary outcome was the Mini-Mental State Examination (MMSE) score. The secondary outcome was the AD Assessment Scale-cognitive subscale (ADAS-cog). |
| Results | Twenty-eight trials were eligible, including 6,863 participants. In the direct meta-analysis, as for the Mini-Mental State Examination scale, the ChEIs (MD: -0.38; 95% CI: -0.74, -0.01), Chinese medicine (MD: -0.31; 95% CI: -0.75, 0.13), exercise therapy (MD: -0.50; 95% CI: -0.65, -0.35), music therapy (MD: -1.71; 95% CI: -4.49, 1.07), were statistically more efficient than placebo. For AD Assessment Scalecognitive subscale outcome, ChEIs (MD: 1.20; 95% CI: 0.73, 1.68), Acupuncture (MD: 1.36; 95% CI: 1.28, 1.44), Chinese medicine (MD: 0.61; 95% CI: 0.49, 0.73) and exercise (MD: 0.61; 95% CI: 0.49, 0.73) were better than placebo. In the network meta-analysis, the MMSE outcome ranked music therapy (59%) as the best and Acupuncture (26%) as second. Nutrition and Ginkgo treatment had the lowest rank among all interventions. For ADAS-cog outcome, acupuncture (52) ranked the best. |
| Conclusion | Among the nine treatments studied, music therapy appears to be the best treatment for MCI, followed by acupuncture. Our study provides new insights into potential clinical treatments for MCI due to AD, and may aid the development of guidelines for MCI in AD. |
1.1.3. Wang 2020
Wang YY, Yu SF, Xue HY, Li Y, Zhao C, Jin YH. Effectiveness and Safety of Acupuncture for the Treatment of Alzheimer's Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci. 2020. [209248]. doi/
| Background | The effects of acupuncture on Alzheimer's disease (AD) outcomes remain controversial. The aim of this review was to evaluate the effectiveness and safety of acupuncture for the treatment of AD. |
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| Methods | PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang Data were searched to identify relevant randomized controlled trials from inception to January 19, 2019. Data were extracted and evaluated by two authors independently. The data analysis was conducted using R (version 3.6.0) and RStudio (version 1.2.1335) software. |
| Results | Thirty trials involving 2,045 patients were included. Acupuncture plus drug therapy may have been more beneficial for general cognitive function in AD patients than drug therapy alone (short-term treatment: MD, mean difference = 1.94, 95% CI: 1.11, 2.77; p < 0.01; medium-term treatment: MD = 4.41, 95% CI: 1.83, 7.00; p < 0.01). People who received acupuncture plus drug therapy attained higher ADL (Activities of Daily Living) scores than patients who received drug therapy alone for medium-term treatment duration (MD = -2.14; 95% CI: -3.69, -0.59; p < 0.01). However, there is no statistically significant difference in subgroup effect on MMSE (Mini-mental Status Examination) and ADLs (p > 0.05) when comparing acupuncture treatment with drug therapy (such as Donepezil hydrochloride, Nimodipine, or Yizhijiannao), or acupuncture plus drug therapy (such as Donepezil hydrochloride, Dangguishaoyaosan, or Jiannaosan) with drug therapy alone. There was also no significant difference in general cognitive function, ADLs, or incidence of adverse events between acupuncture treatment and drug therapy (p > 0.05). |
| Conclusions | This review indicates that acupuncture plus drug therapy may have a more beneficial effect for AD patients than drug therapy alone on general cognitive function in the short and medium term and on ADLs in the medium term. Acupuncture alone may not have superior effects compared with drug therapy on global cognitive function, ADLs, and incidence of adverse events. Duration of treatment may not modify the effect of acupuncture in comparison with drug therapy. Additional large-scale and high-quality clinical trials are needed. |
1.1.4. Huang 2019
Huang Q, Luo D, Chen L, Liang FX, Chen R. Effectiveness of Acupuncture for Alzheimer's Disease: An Updated Systematic Review and Meta-analysis. Curr Med Sci. 2019;39(3):500-511. [199649].
| Background | Acupuncture has reportedly improved memory and cognitive impairment in both animal and clinical studies. It may be an effective treatment for Alzheimer's disease (AD). |
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| Objective | The purpose of this meta-analysis was to review the effectiveness of acupuncture for the treatment of AD. |
| Methods | Eight databases were searched for articles published up to and including July 2017, and 13 studies fulfilling the inclusion criteria were identified. The main outcomes assessed were clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score, Alzheimer's Disease Assessment Scale-Cognition score, Hasegawa's Dementia Scale (HDS) score, and adverse events. The methodological quality of the articles was assessed using Cochrane's risk of bias. All the studies compared the efficacy of acupuncture with that of medication, and were published in Chinese journals. |
| Results | Meta-analysis revealed that acupuncture yielded positive results as determined via all the indexes scored except the HDS (95% CI -0.26 to 0.90, Z=0.35, P=0.73). Only one of the studies reported adverse events associated with acupuncture and medication. The rate of adverse events in the medication group was 13%. In most of the studies assessed in the current meta-analysis, acupuncture alone was better than conventional western medicines for the treatment of AD. |
1.1.5. Wang 2019
Wang Yishen, Xu Jia, Fu Qinhui, Pei Jian. [Acupuncture combined with medicine for cognitive functions and life quality of patients with Alzheimer’s disease: a systematic review]. Shanghai Journal of Traditional Chinese Medicine. 2019;1:19-25. [201736].
| Objective | To systematically evaluate the efficacy and safety of acupuncture combined with medicine for cognitive functions and life quality of the patients with Alzheimer’s Disease ( AD). |
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| Methods | The randomized controlled trials ( RCTs) regarding acupuncture combined with medicine for AD published from January 1st of 2008 to August 31th of 2018 were researched in China National Knowledge Infrastructure, VIP medicine information system, Wan Fang database, Chinese Biomedical Database, PubMed, Medline, Springer Link and Cochrane Library. The quality assessment was performed based on the guidance of the Cochrane Reviewers’ Handbook, and Meta-analyses was performed by using Rev Man 5. 3 software. |
| Results | Totally 8 RCTs were included, Involving 472 AD patients. The results of Meta-analyses showed that the treatment group was superior to the control group in improving the mini-mental state examination (MMSE)MD = 0.76,95%CI [0.42,1.10], P<0.000 01), Alzheimer’s disease assessment scale-cognitive section ( ADAS-cog) ( MD =-0.32,95%CI [-0.61,-0.03],P = 0.03), activities of daily living (ADL)( MD =-0.66,95%CI [-1.06,-0.27],P = 0.001). |
| Conclusion | Acupuncture combined with medicine for cognitive functions and life quality of AD patients is effective. However, the included studies were with risk of bias and with clinical heterogeneity. So more RCTs of high quality are needed to further confirm its efficacy and safety. |
1.1.6. 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. |
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| 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. |
1.1.7. Xu 2015 (combined with western medicine) ☆☆
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). |
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| 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. |
1.1.8. 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. |
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| 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 |
1.1.9. 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. |
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| 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. |
1.1.10. 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. |
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| 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. Combined with Traditional Chinese Medicine
1.2.1.1. Jiao 2020
Jiao Li. [Systematic Review of Acupuncture Combined with Traditional Chinese Medicine in Treatment of Alzheimer's Disease ]. Journal of Hubei Minzu University (Medical Edition). 2020. [212897].
| Objective | The aim of the study is to comprehensively evaluate the clinical efficacy of acupuncture combined with Traditional Chinese Medicine in the treatment of a Alzheimer disease. |
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| Methods | We performed online searches of the CNKI, Wanfang, VIP, PubMed, web of Science (SCI), Medline until July 2019 to find randomized controlled trials about acupuncture combined with Traditional Chinese Medicine in the treatment of Alzheimer disease. Two reviewers independently screened and extracted data according to inclusion and exclusion criteria. Review Manager5. 3 was used to perform the meta-analysis. |
| Results | Totally 12 RCTs involving 737 patients were included eventually. The results of Meta-analysis showed that compared with Western medicine, acupuncture combined with Traditional Chinese Medicine had better efficacy in improving effective rate [RR=1. 29, 95%CI (1. 16, 1. 44)] and MMSE score [WMD=1. 87, 95%CI (0. 76, 2. 98)] (P<0. 01). |
| Conclusion | Current RCTs clinical evidence indicated that acupuncture combined with Traditional Chinese Medicine was better than Western medicine in the treatment of Alzheimer disease, and there was no serious adverse reaction. Due to the small sample size and the generally low quality of included studies, this conclusion still needs support from large sample, multi-center, high-quality randomized controlled research. |
1.2.1.2. Zhou 2017
Zhou S, Dong L, He Y, Xiao H. Acupuncture plus Herbal Medicine for Alzheimer's Disease: A Systematic Review and Meta-Analysis Am J Chin Med. 2017;45(7):1327-1344. [52387].
| Background | Alzheimer's disease (AD) is associated with the unprecedented aging tendency in our world population and has become a significant health issue. The use of Traditional Chinese Medicine to treat AD has been increasing in recent years. |
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| Objective | The objective of this meta-analysis is to evaluate the effectiveness of combining acupuncture with herbal medicine to treat AD. |
| Methods | Randomized controlled trials (RCTs) of acupuncture plus herbals versus treatment with western drugs for AD were retrieved from 11 databases. The data were extracted by two authors; dichotomous data were expressed as odds ratio (Ors) and 95% confidence intervals (Cis), while continuous data were calculated by mean differences (MDs) with 95% Cis. |
| Results | Although the combined analysis of the score of Activity of Daily Life (ADL) scale MD was [Formula: see text]3.59 (95% CI [Formula: see text]7.18-0.01, [Formula: see text]), which indicates there was no statistically significant difference between the two treatments at reducing the ADL scale score, the pooled results of 12 trials indicated that acupuncture plus Chinese herbal medicine was better than western drugs at improving the effectiveness rate (OR 2.24, 95% CI 1.40-3.56), the combined evidence of 11 articles showed that acupuncture plus Chinese herbal medicine was more effective than western drugs at improving the scores for the Mini Mental State Examination (MMSE) scale (2.10, 95% CI 0.69-3.51, [Formula: see text]) and the traditional Chinese medicine symptom (MD 5.07, 95% CI 3.90-6.25, [Formula: see text]). |
| Conclusions | From the current research results, acupuncture plus herbal medicine may have advantages over western drugs for treating AD. Nevertheless, well-designed RCTs with a larger sample size are required in the future. |
1.2.2. Zou 2016 ☆
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. |
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| 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. |
2. Guidelines
2.1. National Institute for Health and Care Excellence (NICE, UK) 2018
Dementia: assessment, management and support for people living with dementia and their carers (NG97). Evidence-based recommendations on diagnosing and managing dementia (including Alzheimer’s disease) . London (UK): National Institute for Health and Care Excellence (NICE). 2018;:43P. [174901]. Annexes realtives à l'acupuncture [174901-b].
| 1.4 Interventions to promote cognition, independence and wellbeing. 1.4.5 Do not offer acupuncture to treat dementia. |
