针刺联合常规西药治疗轻度认知功能障碍的 系统评价和Meta分析

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Abstract] ObjectiveTo systematically evaluate the safetyand efectivenessof acupuncture combined with convention westernmedicineinthe treatmentofmildcognitiveimpairment.MethodsTheChina NationalKnowledge Infrastructure（CNK）， ChinaBiomedicalLiterature Database（CBM），China SciencePeriodical Database（CSPD），China CitationDatabase（CCD）and PubMed，TheCochaneLibrary，EmbaseedicalLiteratureDtabaseweresearchedtocollctandomizedcontroledtrialsubled fromtheestablsmentoftedatabasetoeptember30024inhichcupuncturecombinedwithonventioalwestemdiciat mentwasthemaininterventionforthetreatmentofildcognitiveimpairment.Twoinvestigatorsindependentlyscreenedanderacted theretrievedliterature，evaluatedteualityoftheicudedliteratueaccodingtoteCocaneHandbookiasiskAssesstTool， andthenusedReviewManager5.4softwaretoconductMeta-analysis.ResultsAtotalof13articleswereicluded，involvingatotal of916patientsihildcogitieimpaientMeta-analysisresultsshowedtattetotalclinicaletierateintebseatiogoup （ RR=1.40 ， 95%CI ： 1. 28 to 1.52， P<0.00001 ）and mini-mental state examination（MMSE） scoresafter intervention （ MD=1.79 ，95%CI ： 1.11 to 2.48， P<0.000 01 ），Montreal cognitive assessment （ MoCA ）score（ MD=2. 15，95 %CI ：1.47 to 2. 83， P<0.000 01 ） and activities of daily living（ADL） score （ MD=5，32 ， 95%CI ：2.35 to 8.28， P=0.000 4 ）were better than the control group，and thedifferenceasstatisticallysignificantTeresultsofsubroupanalysisshowedthatterewasnostatisticaldiferenceintheimprovement of MMSE and MoCA scores between acupuncture combined with nimodipine and nimodipine alone （ P>0.05 ）； In the improvementof ADLscores，there wasnostatistical diference betwenacupuncturecombinedwithdonepezilanddonepezillone（ P> （20 0.05）.ConclusionAcupuncturecombined withconventionalwestern medicinecanefectivelyimprovethecognitivefunctionand dailylivingabilitiesofpatientswithmildcognitiveimpairment，andtheeficacyisbeterthanthatofwesternmedicinealone.Ithas highsafetyandfeweradversereactions.However，limitedbythequalityandquantityof incluedliteratureorelarge-sample，multicenter，igqualtydomedonrolledrialsrestillnediefuturetofurtheverifeliicalalatoeofupun ture combined with conventional western medicine treatment in patients with mild cognitive impairment.

Key words] Acupuncture；Mild cognitive impairment；Systematicreview；Meta-analysis

轻度认知功能障碍是一种介于正常衰老与痴呆之间的过渡状态，临床表现形式为遗忘型与非遗忘型，前者包括单纯记忆功能减退或记忆减退伴其他认知功能领域损害，后者包括单个或多个非记忆认知功能领域的损害，如语言、执行、视空间等功能领域[1]。（剩余17022字）