针刺改善血管性痴呆患者认知功能的系统评价

发布时间：2018-05-02 13:04

本文选题：血管性痴呆 + 认知功能　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：运用系统评价的方法对针刺改善血管性痴呆患者认知功能的疗效进行评价,为临床运用针刺治疗血管性痴呆及相关认知功能障碍疾病提供临床证据。方法：严格制定检索策略,全面检索1992年1月至2015年12月的中英文数据库中关于针刺治疗血管性痴呆的相关临床RCT报道。按照制定的标准,筛选检索文献,提取相关数据信息。运用Cochrane协作网推荐的Risk of bias table评定工具对文献进行偏倚评价。采用Revman 5.3软件对纳入指标进行meta-分析,系统评价针刺疗法改善血管性痴呆的患者认知功能的治疗效果。结果：通过全面检索、筛查,本系统评价最终共纳入23项临床随机对照试验,对纳入文献进行方法质量学评价,15篇质量等级为B,8篇质量等级为C,纳入文献质量不高。通过定性、定量分析,结果发现：针刺在有效率、MMSE评分、HDS评分、P300潜伏期检测值、生化学指标上体现出优势。在与多奈哌齐比较时,两者在有效率方面无明显差异。针刺联合西药治疗在有效率、MMSE评分、HDS评分、P300潜伏期检测值、生长抑素及精氨酸加压素、TXB2含量及6-Keto-PGF1α含量等生化学检测方面均体现出优势。结论：1.针刺治疗与西药比较,在改善认知功能疗效在各项检测指标看来更具有优势,证据质量不高,结果稳定。2.目前研究结果表明,针刺改善认知功能的疗效与盐酸多奈哌齐比较在临床疗效上基本相当,结果稳定。3.针刺联合西药治疗与单纯西药治疗比较,在改善认知功能疗效在各项检测指标看来均更均有优势,证据质量不高,结果稳定。4.针刺治疗安全,无不良反应。目前证据质量偏低,虽然针刺改善血管性痴呆患者认知功能的疗效在大多数结局指标中均显示出了优势,但是不排除未来有更多高质量的临床试验纳入,造成结果的改变。
[Abstract]:Objective: to evaluate the efficacy of acupuncture in improving cognitive function in patients with vascular dementia by means of systematic evaluation, so as to provide clinical evidence for the treatment of vascular dementia and related cognitive disorders. Methods: the search strategy was strictly formulated and the related clinical RCT reports on acupuncture treatment of vascular dementia were searched from January 1992 to December 2015 in Chinese and English databases. According to the established criteria, the search documents are selected and the relevant data information is extracted. The bias of the literature was evaluated with the Risk of bias table recommended by the Cochrane Cooperative Network. The effect of acupuncture therapy on cognitive function of patients with vascular dementia was evaluated systematically by meta-analysis of inclusion index with Revman 5.3 software. Results: through comprehensive search and screening, 23 clinical randomized controlled trials were included in the systematic evaluation, and 15 articles were evaluated by the method of quality science. The quality grade of 15 articles was B and 8 articles were C, and the quality of the included articles was not high. Through qualitative and quantitative analysis, it was found that acupuncture had an advantage in effective MMSE score, HDS score and P300 latency. There was no significant difference in efficiency between the two groups when compared with Donepezil. Acupuncture combined with western medicine showed advantages in the effective rate of MMSE score, HDS score and P300 latency, somatostatin and arginine vasopressin TXB2 content and 6-Keto-PGF1 伪 content. Conclusion 1. Compared with western medicine, acupuncture therapy has more advantages in improving cognitive function, and the quality of evidence is not high, and the result is stable. 2. The results show that the efficacy of acupuncture in improving cognitive function is basically the same as that of Donepezil hydrochloride, and the results are stable. Acupuncture combined with western medicine treatment and simple western medicine treatment, in the improvement of cognitive function in the efficacy of all indicators in terms of more advantages, the quality of evidence is not high, the results are stable. 4. Acupuncture is safe and has no adverse reaction. The quality of evidence is on the low side at present. Although the curative effect of acupuncture to improve the cognitive function of vascular dementia patients shows superiority in most outcome indexes, it does not rule out more high quality clinical trials in the future, which results in the change of results.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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