Acupuncture and Related Therapies for the Cognitive Function of Alzheimer’s Disease: A Network Meta-Analysis

Xue-Song  Wang; Jia-Jia  Li; Yue-Shen  Wang; Chao-Chao  Yu; Chuan  He; Zhong-Sheng Huang; Tao  Jiang; Qing  Hao; Li-Hong  Kong

doi:10.18502/ijph.v50i12.7924

Xue-Song Wang College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China
Jia-Jia Li Hubei Rongjun Hospital, Wuhan, Hubei, China
Yue-Shen Wang Xuzhou Cancer Hospital, Xuzhou, Jiangsu, China
Chao-Chao Yu Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangzhou, China
Chuan He College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China
Zhong-Sheng Huang College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China
Tao Jiang College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China
Qing Hao College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China
Li-Hong Kong College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei, China

DOI: https://doi.org/10.18502/ijph.v50i12.7924

Keywords: Acupuncture; Alzheimer's disease; Cognitive function; Network meta-analysis

Abstract

Background: Acupuncture and acupuncture-related therapies are effective for Alzheimer's disease (AD), therefore, we aimed to compare and rank the interventions that mainly focus on acupuncture-related therapies in the treatment of patients with mild to moderate AD.

Methods: We used network meta-analysis to evaluate the direct and indirect evidence shown in randomized controlled trials of AD. The data were analyzed using RavMan manager, Stata, and WinBUGS software after two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies.

Results: We analyzed a total of 36 eligible studies, including 2712 patients, involving 14 types of acupuncture-related therapies and comprehensive therapies. For Mini-Mental State Examination (MMSE), acupuncture (ACU) combined with cognitive and memory training (Training) was more effective than ACU, ACU+Chinese herb (CH), ACU+Donepezil (DON), CH, DON, DON+Nimodipine (NIM), Music therapy (Music), NIM, Placebo, and Training (P<0.05), while ACU+CH was batter than CH (P<0.05), and ACU+DON+NIM was better than DON+NIM (P<0.05). For Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog), ACU was more effective than DON and placebo (P<0.05). For Activities of Daily Living (ADL), ACU+DON was better than CH, DON, NIM, and Placebo (P<0.05). For the clinical effectiveness rate, ACU, ACU+CH, ACU+CH+DON, ACU+CH+DON+NIM, ACU+DON, CH, NIM were all more effective than DON+NIM (P<0.05), while ACU and ACU+CH were better than DON (P<0.05). The comprehensive ranking results show that ACU+training and ACU have the highest ranking probability.

Conclusion: ACU+Training and ACU may be the best therapies to improve the cognitive function of patients with mild to moderate AD, while the combination of acupuncture-related therapies and other therapies has a higher overall benefit.