灸法治疗脑卒中后认知障碍的meta分析

Meta-analysis of moxibustion in the treatment of post-stroke cognitive impairment

目的对灸法治疗脑卒中后认知障碍的研究进行meta分析,分析其效果。方法检索国内外数据库PubMed、Cochrane Library、Web of Science、Embase、CBM、CNKI、WanFang、VIP,检索时间为建库至2022年1月25日。按纳入及排除标准确定纳入文献,采用RevMan 5.4软件进行meta分析。结果共纳入12项RCT,包括824例患者。试验组蒙特利尔认知量表(MoCA)评分[MD=2.44,95%CI(2.02,2.87),P<0.00001]、简易精神状态评价量表(MMSE)评分[MD=1.08,95%CI(0.56,1.60),P<0.0001]、改良Barthel指数(MBI)评分[MD=6.48,95%CI(5.80,7.15),P<0.00001]、治疗有效率[RR=1.30,95%CI(1.13,1.50),P=0.0002]高于对照组;试验组的血清同型半胱氨酸(Hcy)水平[MD=-1.88,95%CI(-3.25,-0.51),P=0.007]低于对照组。结论灸法能有效提高脑卒中后认知障碍患者的认知水平及生活自理能力,但由于文章质量及样本量等限制,上述结论仍有待更多的高质量临床研究去验证。

Objective To conduct a meta-analysis for studies of moxibustion in the treatment of post-stroke cognitive impairment and analyze its effect.Methods Searched in the domestic and foreign databases including PubMed,Cochrane Library,Web of Science,Embase,CBM,CNKI,WanFang and VIP,and the retrieval time from the database establishment to January 25,2022.The included literature was determined according to the inclusion/exclusion criteria,and the RevMan 5.4 software was used for meta-analysis.Results A total of 12 randomized controlled trials(RCTs)were included,including 824 patients.The Montreal Cognitive Assessment(MoCA)score(MD=2.44,95%CI[2.02,2.87],P<0.00001),Mini-Mental State Examination(MMSE)score(MD=1.08,95%CI[0.56,1.60],P<0.0001),Modified Barthel Index(MBI)score(MD=6.48,95%CI[5.80,7.15],P<0.00001),effective rate of treatment(RR=1.30,95%CI[1.13,1.50],P=0.0002)of the experimental group were higher than those of the control group.The level of serum homocysteine(Hcy)(MD=-1.88,95%CI[-3.25,-0.51],P=0.007)in the experimental group was lower than that in the control group.Conclusion Moxibustion can effectively improve the post-stroke cognitive level and self-care ability of patients with post-stroke cognitive impairment.However,due to the limitations including article quality and sample size,the above conclusion still needs to be verified by more high-quality clinical studies.