耳穴疗法在认知障碍和痴呆患者中的应用：一项系统综述和荟萃分析

IF 1.7 Q2 Medicine

Advances in integrative medicine Pub Date : 2025-04-23 DOI:10.1016/j.aimed.2025.100494

Bianca Shieu , Yu-Min Cho , Min Wang , M. Cary Reid , Fayron Epps , Ya-Lun Li , Lixin Song

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引用次数: 0

摘要

背景：穴位按压（APA）已被用于治疗癌症相关疼痛、慢性腰痛、头痛和痛经，并改善焦虑和睡眠质量。然而，它在认知障碍和痴呆人群中的应用还有待研究。本系统综述和荟萃分析旨在总结APA在这些人群中的实施情况，评估其对认知功能和日常生活活动（adl）的影响，提供循证结论，指导未来的研究方向。方法按照PRISMA指南综合检索PubMed、CINHAL、Scopus、b谷歌Scholar、NCKI、Weipu、Wangfang等7个中英文电子数据库。我们的搜索策略利用了与感兴趣的主题相关的关键字和MeSH术语的组合。两位独立研究者筛选检索文章的标题和摘要，然后进行全文筛选，以确定符合条件的研究。与第三位调查员的讨论和协商解决了分歧。我们使用标准化表格进行数据提取，包括研究特征、干预细节、结果和偏倚风险评估。混合方法评估工具评估证据的质量。叙事综合和元分析进行数据综合。结果主要发现包括：(1)有一个通用的APA治疗程序；(2)大多数使用APA辅助治疗的研究显示积极的结果；(3)荟萃分析显示APA治疗显著改善：MMSE评分(13 RCTs；SMD = 0.55, 95 % CI: 0.13-0.97)和MoCA评分(10个rct；SMD = - 1.03, 95 % CI: - 1.79 ~ - 0.28)。高异质性（MMSE的I²= 88 %，MoCA的I²= 89.6 %）表明研究之间治疗效果的大小存在很大差异，这可能归因于研究人群、干预方案和所纳入试验的治疗持续时间的差异。而adl分析（4个rct）显示组间无显著差异（SMD = 0.95, 95 % CI:−1.27 ~ 3.16）。我们的荟萃分析结果显示，APA干预对认知功能有显著改善，表明其在临床实践中有可能成为一种有效的非药物治疗方法。这些发现强调了研究APA对认知障碍和痴呆患者的益处的重要性，为研究开辟了新的途径。医疗保健专业人员可以利用这种理解来提供以患者为中心的护理，有效地定制治疗方法，并增强患者对其治疗过程的参与。

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Application of auricular therapy on individuals with cognitive impairment and dementia: A systematic review and meta-analysis

Background

Auricular point acupressure (APA) has been used to treat cancer-related pain, chronic lower back pain, headache, and dysmenorrhea and to improve anxiety and sleep quality. However, its application in populations with cognitive impairment and dementia is understudied. This systematic review and meta-analysis aim to summarize APA implementation in these populations, evaluate its effects on cognitive function and Activities of Daily Living (ADLs), provide evidence-based conclusions, and guide future research directions.

Methods

We followed the PRISMA guideline to comprehensively search seven electronic English and Chinese databases (PubMed, CINHAL, Scopus, Google Scholar, NCKI, Weipu, and Wangfang). Our search strategy utilized a combination of relevant keywords and MeSH terms related to the topic of interest. Two independent investigators screened the titles and abstracts of the retrieved articles, followed by full-text screening to identify eligible studies. Discussion and consultation with a third investigator resolved disagreements. We used a standardized form for data extraction, including study characteristics, intervention details, outcomes, and risk of bias assessment. The Mixed Methods Appraisal Tool evaluated the quality of evidence. Narrative synthesis and meta-analysis conducted data synthesis.

Results

Key findings include: (1) there is a universal APA treatment procedure, (2) most studies that used APA with an adjunct treatment showed positive results, (3) meta-analyses revealed significant improvements with APA treatment: MMSE scores (13 RCTs; SMD = 0.55, 95 % CI: 0.13–0.97) and MoCA scores (10 RCTs; SMD = −1.03, 95 % CI: −1.79 to −0.28). The high heterogeneity (I² = 88 % for MMSE and 89.6 % for MoCA) indicates substantial variability between studies in the magnitude of treatment effects, which may be attributed to differences in study populations, intervention protocols, and treatment durations across the included trials. While analysis of ADLs (4 RCTs) showed no significant between group differences (SMD = 0.95, 95 % CI: −1.27 to 3.16).

Conclusion

Our meta-analysis results demonstrate significant improvements in cognitive function with APA intervention, suggesting its potential as an effective nonpharmacological therapeutic approach in clinical practice. These findings emphasize the importance of studying APA's benefits for patients with cognitive impairment and dementia, opening new avenues for research. Healthcare professionals can leverage this understanding to provide patient-centered care, tailor treatments effectively, and enhance patient participation in their healing process.

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来源期刊

Advances in integrative medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

3.20

自引率

11.80%

发文量

审稿时长

15 weeks

期刊介绍： Advances in Integrative Medicine (AIMED) is an international peer-reviewed, evidence-based research and review journal that is multi-disciplinary within the fields of Integrative and Complementary Medicine. The journal focuses on rigorous quantitative and qualitative research including systematic reviews, clinical trials and surveys, whilst also welcoming medical hypotheses and clinically-relevant articles and case studies disclosing practical learning tools for the consulting practitioner. By promoting research and practice excellence in the field, and cross collaboration between relevant practitioner groups and associations, the journal aims to advance the practice of IM, identify areas for future research, and improve patient health outcomes. International networking is encouraged through clinical innovation, the establishment of best practice and by providing opportunities for cooperation between organisations and communities.