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OA

Objective To systematically evaluate the safety and effectiveness of acupuncture combined with conventional western medicine in the treatment of mild cognitive impairment.Methods The China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(CBM),China Science Periodical Database(CSPD),China Citation Database(CCD)and PubMed,The Cochrane Library,Embase Medical Literature Database were searched to collect randomized controlled trials published from the establishment of the database to September 30,2024 in which acupuncture combined with conventional western medicine treat-ment was the main intervention for the treatment of mild cognitive impairment.Two investigators independently screened and extracted the retrieved literature,evaluated the quality of the included literature according to the Cochrane Handbook Bias Risk Assessment Tool,and then used Review Manager 5.4 software to conduct Meta-analysis.Results A total of 13 articles were included,involving a total of 916 patients with mild cognitive impairment.Meta-analysis results showed that the total clinical effective rate in the observation group(RR=1.40,95%CI:1.28 to 1.52,P<0.000 01)and mini-mental state examination(MMSE)scores after 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 the difference was statistically significant.The results of subgroup analysis showed that there was no statistical difference in the im-provement of MMSE and MoCA scores between acupuncture combined with nimodipine and nimodipine alone(P>0.05);In the im-provement of ADL scores,there was no statistical difference between acupuncture combined with donepezil and donepezil alone(P>0.05).Conclusion Acupuncture combined with conventional western medicine can effectively improve the cognitive function and daily living abilities of patients with mild cognitive impairment,and the efficacy is better than that of western medicine alone.It has high safety and fewer adverse reactions.However,limited by the quality and quantity of included literature,more large-sample,multi-center,high-quality randomized controlled trials are still needed in the future to further verify the clinical application effect of acupunc-ture combined with conventional western medicine treatment in patients with mild cognitive impairment.