대한예방한의학회지 (Journal of Society of Preventive Korean Medicine)

대한예방한의학회 (Society of Preventive Korean Medicine)
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경도인지장애 침치료 인지기능효과 : 체계적 문헌고찰 메타분석

Cognitive Function Effects of Acupuncture Treatment for Mild Cognitive Impairment : Systematic Literature Review and Meta-Analysis

  • 투고 : 2023.12.05
  • 심사 : 2024.03.07
  • 발행 : 2024.08.31
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⟨ 이전 논문 다음 논문 ⟩

초록

목적 : MMSE와 MoCA 인지 도구를 사용하여 인지 유형에 따른 침치료 효과를 확인하고자 하였다. 체계적 문헌 고찰을 통하여 침치료 적용 방법에 따라 효과성과 침치료 무작위 임상시험 논문의 질을 평가하여 임상시험 논문의 편향성을 파악하고자 하였다. 방법 : 2012년에서 2023년까지 수행된 경도인지장애 침치료 효과에 대한 논문을 문헌고찰과 코크란 메타분석으로 조사한 연구이다. 논문 질 분석도구는 코크란 편향성 위험도구(Cochrane risk of bias : RoB)를 사용하였으며 메타분석 도구는 메타분석용 Cochrane RevMan V5.4.1 (Cochrane Collaboration) 소프트웨어를 사용하였다. 결과 : 분석에 사용한 대상자는 총 967명으로 침치료 무작위 대조군 연구논문 16편이 분석되었다. 결과는 다음과 같다. 경도인지장애 침치료 메타분석 결과 MMSE 평균차이는 1.61로 95% 신뢰구간은 0.14에서 3.07로 p<0.001로 유의하였다. Z=2.15(p=0.03), MoCA 점수는 평균차이는 0.39에서 2.49로 p<0.001), Z=2.70(p=0.007)로 경도인지장애 대상자의 침치료 효과는 유의하였다. 결론 : 경도인지장애 침치료 효과는 유의하였으며, 향후 다양한 유형의 경도인지장애 침치료 무작위대조군 연구를 제안하고자 한다. 이 연구의 의의는 지역사회 경도인지장애 대상자의 예방적 차원의 융합인지 중 재프로그램개발의 기초자료를 제시하였다는데 의의가 있다.

Objectives : Using MMSE and MoCA cognitive tools, this study tried to measure the effect of acupuncture differing by cognitive types. Through the method of PRISMA literature review, this study aimed to understand and improve the acupuncture's effectiveness in its application. Methods : The research method was a literature review and Cochrane meta-analysis of papers on the effectiveness of acupuncture treatments for mild cognitive impairment conducted from 2012 to 2023. The Cochrane risk of bias (RoB) tool was used as a quality analysis tool, and the meta-analysis tool was Cochrane RevMan V5.4.1 software. Results : As a result of the study, a total of 967 subjects were used for analysis, and 16 papers on randomized acupuncture trials were analyzed. The results are as follows: As a result of meta-analysis of acupuncture intervention for mild cognitive impairment, the MMSE score had an average of 1.61 with a 95% confidence interval ranging from 0.14 to 3.07, and a statistically significant result with p<0.001. The Z-score was 2.15, which corresponded to a p-value of 0.03. The MoCA score had an average range between 0.39 and 2.49, also showing statistical significance with p<0.001, and a Z-score of 2.70 (p=0.007). The effect of acupuncture in subjects with mild cognitive impairment was significant. Conclusion : The suggestions and conclusion indicate that acupuncture intervention has a significant effect on mild cognitive impairment. This study propose future experimental research on various types of acupuncture interventions for mild cognitive impairment. The significance of this study is that it presented basic data for the development of a preventive convergence cognitive intervention program for patients with mild cognitive impairment in the community.

키워드

참고문헌

  1. 대한민국 치매현황(Korean Dementia observatory) 2023보고서, 중앙치매센터, 2024.06.28. https://www.nid.or.kr/info/dataroom_view.aspx?bid=284.
  2. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004 Sep;256(3):183-94. https://doi.org/10.1111/j.1365-2796.2004.01388.x
  3. Zhang J, Hu S, Liu Y, Lyu H, Huang X, Li X, Chen J, Hu Q, Xu J, Yu H. Acupuncture Treatment Modulate Regional Homogeneity of Dorsal Lateral Prefrontal Cortex in Patients with Amnesic Mild Cognitive Impairment. J Alzheimers Dis. 2022;90(1):173-184. https://doi.org/10.3233/JAD-220592
  4. Jeong JH, Jung C, Kim J, Kim JY, Kim HS, Park YC, Lee JH, Jung IC. Investigation of combined treatment of acupuncture and neurofeedback for improving cognitive function in mild neurocognitive disorder: A randomized, assessor-blind, pilot study. Medicine (Baltimore). 2021 Sep 17;100(37):e27218.
  5. Huang L, Yin X, Li W, Cao Y, Chen Y, Lao L, Zhang Z, M i Y, Xu S. Effects of Acupuncture on Vascular Cognitive Impairment with No Dementia: A Randomized Controlled Trial. J Alzheimers Dis. 2021;81(4):1391-1401. https://doi.org/10.3233/JAD-201353
  6. Bao X, Li L, Liu H, Shi HF, Xu S, Wang MH, Xie JY. Effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. Anat Rec (Hoboken). 2021 Nov;304(11):2531-2537. https://doi.org/10.1002/ar.24700
  7. Fu L, Wang F, Ma Z, Zhang J, Xiong W, Wang L. Effect of Acupuncture and Rehabilitation Therapy on the Recovery of Neurological Function and Prognosis of Stroke Patients. Comput Math Methods Med. 2022 Feb 22;2022:4581248.
  8. Li W, Wang Q, Du S, Pu Y, Xu G. Acupuncture for mild cognitive impairment in elderly people: Systematic review and meta-analyses. Medicine (Baltimore). 2020 Sep 25; 99(39):e22365. https://doi.org/10.1097/MD.0000000000022365
  9. Zhou L, Zhang YL, Cao HJ, Hu H. [Treating vascular mild cognitive impairment by acupuncture: a systematic review of randomized controlled trials]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Dec;33(12):1626-30. Chinese. PMID: 24517058.
  10. Yao S, Liu Y, Zheng X, Zhang Y, Cui S, Tang C, Lu L, Xu N. Do nonpharmacological interventions prevent cognitive decline? a systematic review and meta-analysis. Transl Psychiatry. 2020 Jan 21;10(1):19.
  11. Cao H, Wang Y, Chang D, Zhou L, Liu J. Acupuncture for vascular mild cognitive impairment: a systematic review of randomised controlled trials. Acupunct Med. 2013 Dec;31(4):368-74. doi: 10.1136/acupmed-2013-010363. Epub 2013 Oct 11.
  12. Tang Y, Wang T, Yang L, Zou X, Zhou J, Wu J, Yang J. Acupuncture for post-operative cognitive dysfunction: a systematic review and meta-analysis of randomized controlled trials. Acupunct Med. 2021 Oct;39(5):423-431. https://doi.org/10.1177/0964528420961393
  13. Kim H, Kim HK, Kim SY, Kim YI, Yoo HR, Jung IC. Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and Meta-analysis. BMC Complement Altern Med. 2019 Jan 8;19(1):13.
  14. Zhan J, Wang X, Cheng N, Tan F. [Electroacupuncture for post stroke cognitive impairment: a systematic review and Metaa-nalyses]. Zhongguo Zhen Jiu. 2017 Oct 12;37(10):1119-25. Chinese.
  15. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hrobjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. J Clin Epidemiol. 2021 Jun;134:178-189. https://doi.org/10.1016/j.jclinepi.2021.03.001
  16. Huang L, Yin X, Li W, Cao Y, Chen Y, Lao L, Zhang Z, Mi Y, Xu S.J Alzheimers Dis. 2021;81(4):1391-1401. https://doi.org/10.3233/JAD-201353
  17. Chen J, Li H, Zeng C, Li J, Zhao B. Evaluation of the recovery outcome of poststroke cognitive impairment after cluster needling of scalp acupuncture therapy based on functional near-infrared spectroscopy. Brain Behav. 2020 Aug;10(8):e01731.
  18. Wang S, Yang H, Zhang J, Zhang B, Liu T, Gan L, Zheng J. Efficacy and safety assessment of acupuncture and nimodipine to treat mild cognitive impairment after cerebral infarction: a randomized controlled trial. BMC Complement Altern Med. 2016 Sep 13;16(1):361.
  19. Jiang C, Yang S, Tao J, Huang J, Li Y, Ye H, Chen S, Hong W, Chen L. Clinical Efficacy of Acupuncture Treatment in Combination With RehaCom Cognitive Training for Improving Cognitive Function in Stroke: A 2 × 2 Factorial Design Randomized Controlled Trial. J Am Med Dir Assoc. 2016 Dec 1;17(12):1114-1122. https://doi.org/10.1016/j.jamda.2016.07.021
  20. Chen L, Fang J, Ma R, Gu X, Chen L, Li J, Xu S. Additional effects of acupuncture on early comprehensive rehabilitation in patients with mild to moderate acute isch emic stroke: a multicenter randomized controlled trial. BMC Complement Altern Med. 2016 Jul 18;16:226.
  21. YANG, H. L., ZHANG, B., Tao, L. I. U., & ZHENG, J. G. (2015). Efficacy of acupuncture in combination with medicine for mild cognitive impairment after cerebral infarction: a randomized controlled trial. World Journal of Acupuncture-Moxibustion, 25(1), 7-12. https://doi.org/10.1016/S1003-5257(15)30002-7
  22. Li N, Li O, Sha Z, Wang Y, Li Z, Li Y, Zhang J, Zhao Z, Xu S, Xu J. Efficacy and Safety of Acupuncture Combined with Yishen Granule in Elderly Adults with Mild Cognitive Impairment: A Multicenter, Randomized Controlled Trial. Altern Ther Health Med. 2023 Jun 23:AT8151.
  23. Kim JH, Cho MR, Shin JC, Park GC, Lee JS. Factors contributing to cognitive improvement effects of acupuncture in patients with mild cognitive impairment: a pilot randomized controlled trial. Trials. 2021 May 12;22(1):341.
  24. Kim JH, Han JY, Park GC, Lee JS. Cognitive Improvement Effects of Electroacupuncture Combined with Computer-Based Cognitive Rehabilitation in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial. Brain Sci. 2020 Dec 14;10(12):984.
  25. Tan TT, Wang D, Huang JK, Zhou XM, Yuan X, Liang JP, Yin L, Xie HL, Jia XY, Shi J, Wang F, Yang HB, Chen SJ. Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients. Neural Regen Res. 2017 Feb;12(2):250-258. https://doi.org/10.4103/1673-5374.200808
  26. Jia B, Liu Z, Min B, Wang Z, Zhou A, Li Y, Qiao H, Jia J. The Effects of Acupuncture at Real or Sham Acupoints on the Intrinsic Brain Activity in Mild Cognitive Impairment Patients. Evid Based Complement Alternat Med. 2015;2015:529675.
  27. Zhang H, Zhao L, Yang S, Chen Z, Li Y, Peng X, Yang Y, Zhu M. Clinical observation on effect of scalp electroacupuncture for mild cognitive impairment. J Tradit Chin Med. 2013 Feb;33(1):46-50. https://doi.org/10.1016/S0254-6272(13)60099-0
  28. Wang Z, Nie B, Li D, Zhao Z, Han Y, Song H, Xu J, Shan B, Lu J, Li K. Effect of acupuncture in mild cognitive impairment and Alzheimer disease: a functional MRI study. PLoS One. 2012;7(8):e42730.
  29. Xi L, Fang F, Yuan H, Wang D. Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial. Trials. 2021 Aug 23;22(1):563.
  30. Zhao, F. Y., Zhang, Z. Y., Zhao, Y. X., Yan, H. X., Hong, Y. F., Xia, X. J., & Hong, X. U. (2018). The effect of electroacupuncture preconditioning on cognitive impairments following knee replacement among elderly: a randomized controlled trial. World journal of acupuncture-moxibustion, 28(4), 231-236. https://doi.org/10.1016/j.wjam.2018.11.003
  31. Zhang Q, Li YN, Guo YY, Yin CP, Gao F, Xin X, Huo SP, Wang XL, Wang QJ. Effects of preconditioning of electro-acupuncture on postoperative cognitive dysfunction in elderly: A prospective, randomized, controlled trial. Medicine (Baltimore). 2017 Jun;96(26):e7375.
  32. Wood, S., & Mayo-Wilson, E. (2012). School-based mentoring for adolescents: A systematic review and meta-analysis. Research on social work practice, 22(3), 257-269. https://doi.org/10.1177/1049731511430836
  33. Higgins J P T, Altman D G, GA,tzsche P C, JA¼ni P, Moher D, Oxman A D et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials BMJ 2011;343 :d5928 doi:10.1136/bmj.d5928
  34. Lee, W. S., Kim, H. J., Kim, K. I., Kim, G. B., & Jin, W. (2019). Intra-articular injection of autologous adipose tissue-derived mesenchymal stem cells for the treatment of knee osteoarthritis: a phase IIb, randomized, placebo-controlled clinical trial. Stem cells translational medicine, 8(6), 504-511. https://doi.org/10.1002/sctm.18-0122
  35. Kim H, Kim HK, Kim SY, Kim YI, Yoo HR, Jung IC. Cognitive improvement effects of electro-acupuncture for the treatment of MCI compared with Western medications: a systematic review and Meta-analysis. BMC Complement Altern Med. 2019 Jan 8;19(1):13.
  36. Harvan JR, Cotter V. An evaluation of dementia screening in the primary care setting. J Am Acad Nurse Pract. 2006;18(8):351-360. https://doi.org/10.1111/j.1745-7599.2006.00137.x
  37. SN ML, Mathias JL, Brennan LC, Stewart S. Validity of the Montreal cognitive assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in a cardiovascular population. J Geriatr Psychiatry Neurol. 2011;24(1):33-38. https://doi.org/10.1177/0891988710390813
  38. Cao H, Wang Y, Chang D, Zhou L, Liu J. Acupuncture for vascular mild cognitive impairment: a systematic review of randomised controlled trials. Acupunct Med. 2013 Dec; 31(4):368-74. https://doi.org/10.1136/acupmed-2013-010363
  39. Peng WN, Zhao H, Liu ZS, Wang S. Acupuncture for vascular dementia. Cochrane Database Syst Rev. 2007 Apr 18;2007(2):CD004987.
  40. Doody RS, Ferris SH, Salloway S, Sun Y, Goldman R, Watkins WE, Xu Y, Murthy AK. Donepezil treatment of patients with MCI: a 48-week randomized, placebo-controlled trial. Neurology. 2009;72(18):1555-1561. https://doi.org/10.1212/01.wnl.0000344650.95823.03
  41. Wang W, Wang LN, Zhang XH, Ma L, Li DJ. A nimodipine interventional study of patients with mild cognitive impairment. Zhonghua Nei Ke Za Zhi. 2006;45(4):274-276.
  42. Lu X, Hongcai S, Jiaying W, Jing H, Jun X. Assessing the Quality of Reports about Randomized Controlled Trials of Acupuncture Treatment on Mild Cognitive Impairment. PLoS One. 2011;6(2):1-6. https://doi.org/10.1371/journal.pone.0016922
  43. Glisky EL, Schacter DL, Tulving E. Computer learning by memory-impaired patients: acquisition and retention of complex knowledge. Neuropsychologia. 1986;24:313-328. https://doi.org/10.1016/0028-3932(86)90017-5