Please wait a minute...
Traditional Medicine Research  2016, Vol. 1 Issue (1): 11-20    DOI: 10.12032/TMR201601003
Orginal Article     
The effect of acupuncture plus drug versus drug alone on patients with mild cognitive impairment: a systematic review
Shuai Ting1,*, Zhang Hui1,*, Yi Li-Juan1, Tian Xu1, Zeng Zi1, Wang Yan2, Song Guo-Min3,**
1Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.
2School of Nursing, Tianjin University traditional Chinese Medicine, Tianjin, China.
3Nursing Department of Tianjin Hospital, Tianjin 400020, China.
Download: HTML     PDF(1188KB)
Export: BibTeX | EndNote (RIS)      

Objective:The aim of this systematic review is to evaluate the effect of acupuncture plus drug versus drug alone on patients with MCI.Methods:A computerized search of the databaseswas performed from inception through February 2015. The screening of literature, the extraction of data and the assessment of methodology were independently undertaken by two reviewers. Then, a meta-analysis was performed by Review manager 5.3 version.Results:A total of 18 RCTs involving 1095 participants were incorporated into this study. Meta-analysis suggested that acupuncture plus drug for MCI could significantly improve Mini-Mental State Examination scores (MMSE) (MD1.73, 95% CI 1.28 to 2.18, random-effects model, P<0.00001, 12trials). Activities of Daily Livingscores(ADL) could be significantly improved (MD 5.63, 95%CI 4.40 to 6.87, fixed-effect model, P<0.001, 6 trials).Conclusion:With present evidences, acupuncture plus drug is more effective than drug alone for the treatment of MCI.



Key wordsAcupuncture      Drug      Mild cognitive impairment      Meta-analysis     
Published: 15 December 2015
Corresponding Authors: Shuai Ting,Zhang Hui,Song Guo-Min   
About author:

Executive Editor: Cui-Hong Zhu

English Editor: Lin Li, Li-Yun-Cui, Ya-Song Wang, Xiao-Hua Zhang, Xiao-Dong Wang, Hong-Xu Zhu, Zhen-Yan Liu, Yi-Cheng Shi

Cite this article:

Shuai Ting, Zhang Hui, Yi Li-Juan, Tian Xu, Zeng Zi, Wang Yan, Song Guo-Min. The effect of acupuncture plus drug versus drug alone on patients with mild cognitive impairment: a systematic review. Traditional Medicine Research, 2016, 1(1): 11-20. doi: 10.12032/TMR201601003

URL:

https://www.tmrjournals.com/tmr/EN/10.12032/TMR201601003     OR     https://www.tmrjournals.com/tmr/EN/Y2016/V1/I1/11

Included studies Participants
T C
Mean age(year)
T C
Diagnostic criteria Allocation
Hu Jun 201420 10\25 14\21 76-90 75-92 IC random number table
Zhao Weifeng 201321 17\13 16\14 45-85 41-79 IC randomization
Li Xiaohong 201322 23\16 25\14 62.8±5.9 61.9 ±6.8 IC random number table
Jiao Zhihong 201123 30 30 --- --- IC draw
Lin Fei 201324 16\18 14\20 66-78 65-76 IC randomization
Luo Zhan
201325
40 40 --- --- IC randomization
Sun Yuanzheng
200726
16\14 14\15 65.7 64.9 IC random number table
Sun Yuanzheng
201227
12\8 11\9 65±4 66±5 IC randomization
Wang Fang
201428
30 30 --- --- IC randomization
Zhao Yu 201229 17\13 16\14 57-74 58-74 IC random number table
Zhao Yanhong
201230
18\12 16\14 55.34±8.48 58.14±9.15 IC random number table
Sun Yuanzheng
201013
10\10 10\10 67±9 68±9 IC randomization
Li Wei 201231 30\18 24\22 68.29±8.22 69.22±7.88 GC random number table
Zhen Qi 201432 17\13 19\11 68.33±8.33 66.83±8,55 GC random number table
Bao Yu 201233 19\11 21\9 62.8±5.6 63.5 ± 6.3 IC random number table
Li Wei 201034 15\9 12\10 68.29±8.3 68.82±7.91 IC random number table
Zhang Yanan
201435
17\13 16\14 70.9±5.62 71.27±5.91 IC draw
Li Kunshan
201114
8\12 9\11 65.1±7.25 66±7.43 IC randomization
Table1 The main characteristics of included studies.
Included
studies
Intervention
acupuncture plus drug drug alone
Duration
(week)
Outcome measures
Hu Jun 201420 body acupuncture: 30min/d, 6times/week oxiracetam:4.0g,Qd Oxiracetam 3 MMSE, effect rate ADL
Zhao Weifeng 201321 body acupuncture:30min/d, 6times/week aniracetam:0.2g,tid Aniracetam 24 MMSE,ADL,NCSE
Li Xiaohong 201322 electro acupuncture: 30min/d, QOD donepezil:5mg/d Donepezil 12 MMSE, MoCA, BBS, ADL
Jiao Zhihong 201123 scalp acupuncture: 30min/d, QOD
donepezil:5mg/d,hs
Donepezil 4 MMSE,ADL
Lin Fei 201324 body acupuncture: 40min/d
duxil:40mg/times, bid
Duxil 8 effect rate
Luo Zhan 201325 electric scalp acupuncture: 30min/d, QOD nimodipine:30mg,tid Nimodipine 8 MMSE
Sun Yuanzheng
200726
body acupuncture,30min/d,
6times/week.donepezil:2.5mg/d,pc
Donepezil 8 scale made
by china
Sun Yuanzheng
201227
body acupuncture,40min/d,6times/week,
donepezil:0.25mg/d,pc
Donepezil 4 MMSE,P3\N2,
effect rate
Wang Fang
201428
body acupuncture:30min/d,6times/week.
nimodipine:30mg/d,tid
Nimodipine 12 MoCA, NAA/Cr
Cho/Cr
Zhao Yu 201229 electro acupuncture: 30min/d QOD nimodipine:30mg/time.tid Nimodipine 8 MMSE
Zhao Yanhong
201230
body acupuncture, 4times/weeks
nimodipine:30mg/d,tid
Nimodipine 8 MMSE, MoCA, ERP
Sun Yuanzheng
201013
electro acupuncture: 30min/d,6times/week donepezil5mg/d,hs Donepezil 4 MMSE, MoCA, ERP
Li Wei 201231 electro acupuncture:30min/d 5times/week, nimodipine 30mg/time.tid Nimodipine 12 MMSE,ADL,HDS-R
Zhen Qi 201432 body acupuncture: 30min/d, 6times/week.
nimodipine 30mg/d,tid
Nimodipine 8 MMSE, ADL, MoCA
Bao Yu 201233 body acupuncture,50min/time, 1time/day donepezil:5mg,Qd Donepezil 8 MMSE, MoCA, ADL
Li Wei 201034 body acupuncture,30min/time, 5times/week nomodipine 30mg,tid Nimodipine 12 MMSE,HDS-R,ADL
Zhang Yanan
201435
body acupuncture,30min/d,5times/week,
20times totally. nimodipine 20mg,tid
Nimodipine 4 MMSE, MoCA
Li Kunshan
201114
body acupuncture: 30min/day,6times/week donepezil:5mg,Qd Donepezil 4 MMSE MoCA, ERP
Table 2 The main intervention of included studies.
Figure1 Flow diagram of literature retrieval andscreening.
Figure2 Assessment of Risk of Bias.
Figure3 Meta-analysis on MMSE
Figure 4 Sensitivity Analysis on MMSE.
Figure 5 Funnel Plot on MMSE.
Figure 6 Meta-analysis on ADL.
1.   Petersen. Mild cognitive impairment as a diagnostic entity. Journal of internal medicine 2004;256:183-94.
doi: 10.1111/j.1365-2796.2004.01388.x pmid: 15324362
2.   Petersen, Doody, Kurz, et al. Current concepts in mild cognitive impairment. Archives of neurology 2001;58:1985-92.
3.   Albert, DeKosky, Dickson, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & dementia : the journal of the Alzheimer's Association 2011;7:270-9.
4.   Petersen. Clinical practice.Mild cognitive impairment. The New England journal of medicine 2011;364:2227-34.
5   5.National Center for Health Statistics. [Accessed on March 23, 2013.] National Vital Statistics System. Multiple cause-of-death files.Available from: .
6.   Cooper, Li, Lyketsos, et al. Treatment for mild cognitive impairment: systematic review. The British journal of psychiatry : the journal of mental science 2013;203:255-64.
7.   Zeng, Salvage, Jenner. Effect and mechanism of acupuncture on Alzheimer's disease. International review of neurobiology 2013;111:181-95.
doi: 10.1016/B978-0-12-411545-3.00009-2 pmid: 24215923
8.   Han, Yin,Zhou, et al. Investigation on the changes of dependent signal on the amplitude of low frequency fluctuations at blood oxygen level in brain after acupuncture Neiguan (PC 6). Zhongguo zhen jiu = Chinese acupuncture & moxibustion 2009;29:647-51.
9.   Zhu XT.Influences of acupuncture with effects of awakening consciousness and improving intelligence in group acupoints on brain resting state function. J Beijing Univ Tradit Chin Med 2011;34:181-5.
doi: 10.1111/j.1745-4603.2010.00262.x
10.   Barnes, Bloom, Nahin. Complementary and alternative medicine use among adults and children: United States, 2007. National health statistics reports 2008:1-23.
11.   Cao, Wang, Chang, et al. Acupuncture for vascular mild cognitive impairment: a systematic review of randomised controlled trials. Acupuncture in medicine : journal of the British Medical Acupuncture Society 2013;31:368-74.
doi: 10.1136/acupmed-2013-010363 pmid: 24123487
12.   Zhou, Zhang, Cao, et al. Treating vascular mild cognitive impairment by acupuncture: a systematic review of randomized controlled trials. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban 2013;33:1626-30.
13.   Sun, Li.Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication(in Chinese). Shanghai Journal of acupuncture and moxibustion2010;29:759-61.
14   14.Li, Sun. Clinical observation on the treatment of mild cognitive impairment by combined acupuncture and medication(in Chinese). [dissertation].issertation]. Heilongjiang: Heilongjiang University of Traditional Chinese medicine 2011.
15.   Stone. Popping the (PICO) question in research and evidence-based practice. Applied nursing research : ANR 2002;15:197-8.
doi: 10.1053/apnr.2002.34181 pmid: 12173172
16.   MacPherson, Altman, Hammerschlag, et al. R许正洋evised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. Acupuncture in medicine : journal of the British Medical Acupuncture Society 2010;28:83-93.
17.   Higgins, Green. Cochrane handbook for systematic reviews of interventions version 5.0.0.2008; London: The Cochrane Collaboration.
18.   Brok, Thorlund, Gluud. Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta-analyses. J Clin Epidemiol 2008;61:763-9.
doi: 10.1016/j.jclinepi.2007.10.007 pmid: 18411040
19.   Higgins, Deeks.Chapter 7: Selecting studies and collecting data. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. 2011.
20.   Hu, Wang, Liang. "Activiting brain and regaining consciousness" acupuncture treats the elder with mild cognitive impairment :70 cases(in Chinese). World Health Digest2014:279.
21.   Zhao, Lu, Jia, et al. The effect of Bushen Yisui acupuncture plus draganon on the patients with mild cognitive impairment after stroke(in Chinese). Shanxi Journal of Traditional Chinese Medicine2013;34:1385-6.
22.   Li, Yu, Cao, et al. Clinical observation of electroacupuncture with aricept on preventing participants with MCI progressing to AD(in Chinese). Laser Journal2013;34:75-6.
23.   Jiao, Shi, Xu, et al. Clinical observation on the treatment of mild cognitive impairment by combined scalp acupuncture and medication(in Chinese). Journal of Clinical Acupuncture and Moxibustion2011;27:23-4.
24.   Lin, Yin, Shi. The treatment for mild cognitive impairment by combined scalp acupuncture and medication(in Chinese). National medical frontiers of China2013;8:76.
25.   Luo, Zhen, Li, et al. Efficacy of combined treatment of drugs and electric acupunture on cognitive function of patients with mild cognitive impairment(in Chinese). China medical herald2013;10:118-22.
26.   Sun, Zhu, Zhang. The treatment of mild cognitive impairment by Yuan-primary and Luo-connecting needling method plus aricept:30 cases(in Chinese). Chinese Journal of Traditional Medical Science and Technology2007;14:180.
27.   Sun, Sun, Zhang. Effect of Yuan-primary and Luo-connecting needling method plus medication on P300 in patients with mild cognitive disorder(in Chinese). Shanghai J Acu-mox2012;31:12-4.
28.   Wang, Liang, Huang, et al. Study of magnetic resonance spectroscopy on the treatment of mild cognitive impairment after stroke by acupuncture(in Chinese). Journal of Emergency in Traditional Chinese Medicine2014;23:1928-30.
29.   Zhao, Liu, Liu. Clinical observation of the treatment of mild cognitive impairment by combined acupuncture and nimodipine(in Chinese). Journal of Military Surgeon in Southwest China2012;14:36-8.
30.   Zhao. Clinical observation of the treatment of mild cognitive impairment by combined acupuncture and nimodipine(in Chinese). Clinical Rational Drug Use2012;5:16-7.
31.   Li, Cheng, Yu. Observation on therapeutic effect of acupuncture combined with medicine on mild cognitive disorders in patients with post-stroke(in Chinese). Chinese acupuncture and moxibustion2012;32:3-7.
32   32.Zhen. Clinical study on treatment on mild cognitive impairment after stroke by Yishen Tiaodu acupuncture(in Chinese). [dissertation].issertation]. Heilongjiang: Heilongjiang University of Traditional Chinese medicine 2014.
33   33.Bao.Clinical study on mild cognitive impairment after stroke treated with cord-supplement and brain-strengthening acupuncture(in Chinese). [dissertation].issertation]. Heilongjiang: Heilongjiang University of Traditional Chinese medicine 2012.
34   34.Li. Clinical observation of the effect of acupuncture on mild cognitive impairment after stroke(in Chinese). [dissertation].issertation]. Beijing: Beijing University of Chinese medicine 2010.
35   35.Zhang.Observation of mild cognitive dysfunction after stroke's treatment by the combinition with acupuncture andmedicine(in Chinese). [dissertation].issertation]. Nanjing: Nanjing University of Chinese medicine 2014.
36.   Li, Yang.An fMRI study of acupuncture-induced brain activation of aphasia stroke patients. Complement Ther Med 2011;19:49-59.
doi: 10.1016/j.ctim.2010.11.004 pmid: 21195295
37.   Wang, Nie, Li, et al. Effect of acupuncture in mild cognitive impairemnt and Alzheimer Disease: a functional MRI study. PLoS One 2012;7.
doi: 10.1371/journal.pone.0042730 pmid: 3423412
38.   Lene V, Baram S, Takakura N, et al.Can acupuncture treatment ba double-blinded? An evaluation of double-blinded acupuncture treatment postoperative pain. PLoS One 2015;10.
doi: 10.1371/journal.pone.0119612 pmid: 25747157
[1] Kai Zhang, Ge-Li Jiang, Lei Xiao, Li-Tai Chen. A multi-center randomized controlled clinical trial of three-step acupuncture and cupping therapy for cervicogenic headache[J]. Traditional Medicine Research, 2019, 4(1): 33-41.
[2] Cui-Mei Liang, Xiao-Man Wang, Song-Ge Sun, i Hu. A clinical study on medical cupping for metabolic syndrome with abdominal obesity[J]. Traditional Medicine Research, 2019, 4(1): 4-11.
[3] Jian Hao, Shi-Jun Li. Recent advances in network pharmacology applications in Chinese herbal medicine[J]. Traditional Medicine Research, 2018, 3(6): 260-272.
[4] Zu-Ling Jiang, An Huang, Gui-Yan Deng, Jing Xu, Jing Tang, Feng-Zhen Liang. Clinical efficacy of combined skin acupuncture and external washing therapy of Zhuang nationality medicine in the treatment of chronic eczema[J]. Traditional Medicine Research, 2018, 3(5): 237-242.
[5] Wen-Qi Huang, Zhu Yang, Dong-Xin Tang, Feng-Xi Long, Li Luo, Bing Yang, Juan Li, Jie Chen. Pharmacological intervention of traditional Chinese medicine for the quality of life in patients with colorectal cancer: a systematic review and meta-analysis[J]. Traditional Medicine Research, 2018, 3(2): 95-105.
[6] Jian Huo, Ke-Yu Zhu, Qian Yang, Wen Liu, Jun-Guo Duan. Clinical evidence and potential mechanisms of Chinese medicines for the treatment of diabetic retinopathy[J]. Traditional Medicine Research, 2018, 3(2): 70-81.
[7] Yan-Li Chen, Yun-Rui Jin, Yi-Hua Fan, Qiang Zhang. Meta-analysis of neostigmine injections given at the Zusanli (ST 36) acupoint in the treatment of postpartum urinary retention[J]. Traditional Medicine Research, 2018, 3(2): 106-114.
[8] Zhang Qi-Wen, Chen Bo, Calista Lim Hui-min, Yu Nan-Nan, Guo Yi. Assessing acupuncture effect in the real world study[J]. Traditional Medicine Research, 2017, 2(2): 94-99.
[9] Fan Yi-Hua. A Hemorrhoids Topical Formula[J]. Traditional Medicine Research, 2016, 1(4): 219-221.
[10] Liu Ji-Ye, Chen Ying-Hua. Effects of acupuncture treatment for irritable bowel syndrome: a systematic review and meta-analysis[J]. Traditional Medicine Research, 2016, 1(4): 183-194.
[11] Wu Chao-Yong, Wu Guang-Fu, Wang Xin-Yu. A new idea of electro-acupuncture treatment for peripheral facial paralysis and the nerve-endocrine hypothesis[J]. Traditional Medicine Research, 2016, 1(4): 177-182.
[12] Yi Li-Juan, Tian Xu, Shuai Ting, Zeng Zi, Ma Li, Song Guo-Min. Effects and safety of acupuncture for DFUs: a systematic review and meta-analysis[J]. Traditional Medicine Research, 2016, 1(1): 2-10.
[13] Xiao-Yi Tang, Wen-Ru Shang, Zhi-Wen Weng, Rui-Jin Qiu, Jin-Hui Tian, Yan-Gang Liu, Gui-Hua Tian. Massage for migraine: A meta-analysis[J]. Traditional Medicine Research, 2016, 1(1): 32-42.