灸法对认知衰弱老年人认知功能影响的网状Meta分析-现代医学

灸法对认知衰弱老年人认知功能影响的网状Meta分析

单位：1. 辽宁中医药大学护理学院, 辽宁沈阳 110847;
2. 辽宁中医药大学附属医院护理部, 辽宁沈阳 110032

分类号：R277.7

出版年·卷·期（页码）：2025·53·第四期（584-594）

摘要：

目的： 运用网状Meta分析方法评价灸法对认知衰弱(CF)老年人认知功能的干预效果，寻找改善CF老年人认知功能的最佳灸法方案。方法： 计算机检索Cochrane Library、PubMed、Web of Science、Embase、CINAHL、中国知网、万方数据库、中文科技期刊数据库和中国生物医学文献数据库中有关灸法改善CF老年人认知功能的随机对照试验(RCT)，检索时间均从建库至2024年6月。由两名研究者独立筛选文献、提取资料，并对纳入的研究进行偏倚风险评价，采用Stata 15.1软件进行统计分析。结果： 共纳入14项研究，涉及8种灸法、3种治疗持续时间、4种治疗频率和3种治疗疗程。网状Meta分析结果显示：(1)灸法类型排序：药线点灸、电子灸、药灸+针刺+健康教育、艾灸盒艾灸+多重任务功能训练、隔附子饼灸+悬灸、药线点灸+壮医毛桃土参方、直接灸(无瘢痕灸)、艾灸盒艾灸；(2)治疗持续时间排序：20、30、10～15 min·次^-1；(3)治疗频率排序：5、3、6次·周^-1及隔天1次；(4)治疗疗程排序：30、56、60 d。结论： 现有证据表明，药线点灸、20 min·次^-1、5次·周^-1、共治疗30 d可能是改善CF老年人认知功能较为有效的灸法方案。

Objective: To assess the intervention effects of moxibustion on cognitive function in older adults with cognitive frailty(CF) using a network Meta-analysis(NMA), and to identify the optimal moxibustion strategy for improving cognitive function in older adults with CF. Methods: Comprehensive computer searches for randomized controlled trial(RCT) of moxibustion to improve cognitive function in older adults with CF were conducted in the Cochrane Library, PubMed, Web of Science, Embase, CINAHL, CNKI, Wanfang database, VIP and CBM from the inception of the library until June 2024. Two researchers independently screened the literature, extracted the data and assessed the risk of bias of the included studies, and used Stata 15.1 software for statistical analysis. Results: A total of 14 studies were included, involving 8 types of moxibustion methods, 3 treatment durations, 4 treatment frequencies and 3 treatment courses. NMA showed that: (1) Ranking of moxibustion Methods: medicated thread moxibustion,electronic moxibustion,medicinal moxibustion+acupuncture+health education,moxibustion box moxibustion+multi-task function training,sandwiched moxibustion+suspension moxibustion,medicated thread moxibustion+prescription,direct moxibustion,moxibustion box moxibustion;(2) Ranking of treatment durations: 20 min·time^-1,30 min·time^-1,10-15 min·time^-1;(3) Ranking of treatment frequencies:5 times·week^-1,3 times·week^-1, 6 times·week^-1, once every other day;(4) Ranking of treatment courses:30 d, 56 d, 60 d. Conclusion: The current evidence shows that moxibustion with medicated thread moxibustion, 20 min·time^-1, 5 times·week^-1 for a total of 30 d may be the more effective moxibustion regimen to improve the cognitive function of older adults with CF.

参考文献：

[1] TANG H,ZHU H,SUN Q,et al.Transitions in the cognitive frailty states in community-living older adults:a 6-year prospective cohort study[J].Front Aging Neurosci,2021,13:774268.
[2] KELAIDITI E,CESARI M,CANEVELLI M,et al.Cognitive frailty:rational and definition from an(I.A.N.A./I.A.G.G.) international consensus group[J].J Nutr Health Aging,2013,17(9):726-734.
[3] GAJDOSOVA L,JAKUS V,MUCHOVA J.Understanding cognitive frailty in aging adults:prevalence,risk factors,pathogenesis and non-pharmacological interventions[J].Bratisl Lek Listy,2023,124(9):647-652.
[4] ZHANG X M,WU X J,CAO J,et al.Association between cognitive frailty and adverse outcomes among older adults:a Meta-analysis[J].J Nutr Health Aging,2022,26(9):817-825.
[5] 衡先培,杨柳清.中医内科临床诊疗指南·老年衰弱(制定)[J].中华中医药杂志,2020,35(8):4030-4035.
[6] 刘畅,郑成强,胡琼,等.基于艾灸三因素探讨三才益智灸法治疗轻度认知障碍的研究思路[J].四川中医,2019,37(10):15-17.
[7] 王羽乔琳,秦元梅,钟远,等.督灸对老年衰弱前期患者衰弱水平及认知功能的影响[J].中医学报,2023,38(3):654-657.
[8] 陈瑶,曾雪扬,刘涤非,等.网状Meta分析在中医药领域的发表质量现状与应用价值[J].中国中药杂志,2019,44(24):5322-5328.
[9] HIGGINS J P,ALTMAN D G,GØTZSCHE P C,et al.The Cochrane collaboration's tool for assessing risk of bias in randomised trials[J].BMJ,2011,343:d5928.
[10] THOM H,WHITE I R,WELTON N J,et al.Automated methods to test connectedness and quantify indirectness of evidence in network Meta-analysis[J].Res Synth Methods,2019,10(1):113-124.
[11] WATT J,TRICCO A C,STRAUS S,et al.Research techniques made simple:network Meta-analysis[J].J Invest Dermatol,2019,139(1):4-12.e1.
[12] CHAIMANI A,SALANTI G.Using network meta-analysis to evaluate the existence of small-study effects in a network of interventions[J].Res Synth Methods,2012,3(2):161-176.
[13] MAI W,ZHANG A,LIU Q,et al.Effects of moxa cone moxibustion therapy on cognitive function and brain metabolic changes in MCI patients:a pilot(1)H-MRS study[J].Front Aging Neurosci,2022,14:773687.
[14] XU K,WEI Y,LIU C,et al.Effect of moxibustion treatment on degree centrality in patients with mild cognitive impairment:a resting-state functional magnetic resonance imaging study[J].Front Hum Neurosci,2022,16:889426.
[15] 朱才丰,杨骏,费爱华,等.艾灸督脉组穴治疗轻度认知功能障碍疗效观察[J].上海针灸杂志,2010,29(11):695-697.
[16] 陈炜,朱小敏,廖乃彬,等.壮医毛桃土参方联合药线点灸治疗老年轻度认知障碍临床观察[J].广西中医药大学学报,2023,26(5):22-24,30.
[17] 张亚飞.壮医药线灸对MCI的疗效、MMSE评分和血脂影响的研究[D].南宁：广西中医药大学,2017.
[18] 黄恩婷,李珊珊,陈悦琦,等.通督调神法针灸治疗轻度认知障碍的临床疗效观察[J].世界科学技术-中医药现代化,2019,21(4):696-702.
[19] 赵利华,余璧含,农秀程,等.轻度认知功能障碍患者血清、尿液8-异前列腺素F2α的变化与认知功能的相关性及艾灸调养对其的影响[J].中国老年学杂志,2019,39(15):3699-3703.
[20] 苏嘉惠.艾炷灸对轻度认知障碍患者海马功能连接调节的初步研究[D].南宁：广西中医药大学,2019.
[21] 贾新燕,谭婷婷,王单,等.调神益智艾灸法对轻度认知障碍患者认知功能及睡眠质量疗效观察[J].康复学报,2017,27(6):5-8.
[22] 杨雪艳.“三才益智”灸法治疗轻度认知障碍的临床疗效评价[D].成都：成都中医药大学,2016.
[23] 汪海燕,李思妤,胡琼,等.“三才益智”灸结合“同时多重任务”认知康复模式治疗轻度认知障碍的随机对照研究[J].中华中医药杂志,2021,36(11):6884-6887.
[24] 李思妤.艾灸结合认知训练对轻度认知障碍患者认知功能及血清Aβ_(1-42)、Tau、P-tau水平的影响[D].成都：成都中医药大学,2020.
[25] 柳奇奇,陈尚杰,申国明,等.电子灸对遗忘型轻度认知障碍患者记忆功能的影响[J].中国针灸,2020,40(4):352-356.
[26] 余璧含.轻度认知障碍患者8-异前列腺素F2α变化的相关分析及艾灸调养的研究[D].南宁：广西中医药大学,2018.
[27] 叶钰.八段锦对认知衰弱老年人氧化应激和慢性炎症的影响研究[D].福州：福建中医药大学,2022.
[28] 常诚,王昕,符为民,等.痴呆的中医病名探析[J].中医杂志,2014,55(24):2078-2080.
[29] 湾明月.基于海马亚区体积探索八段锦改善认知衰弱症的机制[D].福州：福建中医药大学,2021.
[30] 代景妍,张杰,陈瑞丹,等.轻度认知障碍中西医干预进展[J].中国中医基础医学杂志,2021,27(4):678-682.
[31] 梁旖旎.艾灸在轻度认知障碍患者治疗中的应用效果[J].吉林医学,2024,45(6):1502-1504.

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