摘要
目的 采用网状Meta分析评价不同非药物干预对老年轻度认知障碍患者认知功能的效果。方法计算机检索PubMed、Embase、Cochrane Library、CINAHL、CNKI、WanFang Data、VIP和CBM数据库,搜集与研究目的相关的随机对照试验(RCT),检索时限均为建库至2022年11月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0和Open BUGS 3.2.3软件进行网状Meta分析。结果 共纳入43个RCT,包括2 986例患者,涉及8种非药物干预方式。最佳概率排序结果显示,在简易精神状态量表(MMSE)评分方面:重复经颅磁刺激(rTMS)>穴位按摩>针刺治疗>运动疗法>认知训练>多成分干预>虚拟现实技术(VR)>常规护理>健康教育;在蒙特利尔认知评估量表(MoCA)评分方面:VR>运动疗法>rTMS>针刺治疗>穴位按摩>认知训练>健康教育>常规护理。结论 当前证据显示,rTMS、穴位按摩、VR、运动疗法和针刺治疗可能是改善老年轻度认知障碍患者认知功能较为有效的干预方式。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective To evaluate the efficacy of different non-pharmacological interventions on cognitive function in elderly patients with mild cognitive impairment by the network meta-analysis.Methods The PubMed,Embase,Cochrane Library,CINAHL,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect randomized controlled trials(RCTs)related to the objectives from inception to November 2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.The network metaanalysis was then performed by using Stata 16.0 and Open BUGS 3.2.3 software.Results A total of 43 RCTs involving 2986 patients were included,which involved 8 non-drug intervention methods.The best probability ranking results of the network meta-analysis showed that on the simple mental state scale(MMSE)scores:rTMS>acupressure>acupuncture therapy>exercise therapy>cognitive training>multicomponent intervention>VR>conventional care>health education,and on the Montreal cognitive assessment scale(MoCA)scores:VR>exercise therapy>rTMS>acupuncture therapy>acupressure>cognitive training>health education>conventional care.Conclusion Current evidence shows that rTMS,acupressure,VR,exercise therapy and acupuncture may be effective interventions to improve cognitive function in elderly patients with mild cognitive impairment.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.
作者
周子淇
云洁
李宛霖
何思颖
何玲
ZHOU Ziqi;YUN Jie;LI Wanlin;HE Siying;HE Ling(College of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 610072,P.R.China;Department of Hospital Infection,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2023年第11期1305-1312,共8页
Chinese Journal of Evidence-based Medicine
基金
四川省护理科研课题计划项目(编号:H18004)。
关键词
轻度认知障碍
非药物干预
网状Meta分析
系统评价
随机对照试验
Mild cognitive impairment
Non-pharmacological intervention
Network meta-analysis
Systematic review
Randomized controlled tria
