Systematical Review and Meta Analysis of the Efficacy of Acupuncture and Moxibustion plus Cognitive Rehabilitation Training in Treating Post-stroke Cognitive Disorder / 上海针灸杂志

ABSTRACT

ObjectiveTo systematically assess the efficacy of acupuncture and moxibustion plus cognitive rehabilitation training in treating post-stroke cognitive disorder.MethodA computer searched CNKI, CBM, VIP, WANFANG DATA, and Pubmed and Cochrane Library for randomized controlled trials (RCT) of acupuncture and moxibustion plus cognitive rehabilitation training for the treatment of post-stroke cognitive disorder. The reference literature in the included literature was also retrieved. Retrieval time limit for both of them was from Jan. 1st 1990 to Jan. 1st 2015. Two reviewers independently selected the trials, extracted the data and assessed the quality of methodology. Meta analysis was then performed using RevMan 5.3 software.ResultEleven trials with a total of 789 subjectswere finally included. The results of Meta analysis showed that the following aspects were better in acupuncture plus cognitive rehabilitation training than in cognitive rehabilitation training or medication alone and there were statistically significant differences the total efficacy rate [RR=1.58, 95%CI(1.10,2.26),P=0.01], the MMSE score [MD=2.64, 95%CI(1.78, 3.50),P<0.00001], P300 latency [MD=﹣18.46, 95%CI(﹣30.51,﹣6.41),P=0.003], P300 amplitude [MD=1.23, 95%CI(0.82, 1.63),P<0.00001] and activities of daily living (ADL) [SMD=0.52, 95% CI(0.31, 0.73),P<0.00001]. Based on the results of a systematical review, thequality of evidence was assessed using GRADE system recommended classification method. The results showed that the level of evidence was low and the strength of recommendations was weak.ConclusionThe results of Meta analysis showed that the therapeuticeffect was better in acupuncture and moxibustion plus cognitive rehabilitation training than in cognitive rehabilitation training or medication alone. Because of low quality of all the original literature, high-quality, multicenter and large-sample randomized blind controlled trials are still needed for validation.