Acupuncture for the treatment of tumor-related cognitive dysfunction: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Daohong , NI Xixiu , ZHOU Ziyang , QI Wenchuan ,  ZHAO Ling

College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;

Corresponding?author：

ZHAO Ling, Email: zhaoling@cdutcm.edu.cn

Keywords：

Tumor; Cognitive dysfunction; Acupuncture; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202204143

Video：

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Objective To systematically review the efficacy and safety of acupuncture for the treatment of tumor-related cognitive dysfunction. Methods The PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on acupuncture for the treatment of tumor-related cognitive dysfunction from the establishment of the database to February 13^th, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4.1 software. Results A total of 16 studies involving 1 361 patients were included. The results of meta-analysis showed that the mini-mental state examination (MD=1.82, 95%CI 1.49 to 2.15, P<0.000 01) and Montreal cognitive assessment (MD=1.56, 95%CI 0.83 to 2.29, P<0.0001) scores of the acupuncture treatment group were superior to those in the control group. Furthermore, the acupuncture treatment group showed a reduced incidence of postoperative cognitive dysfunction (RR=0.50, 95%CI 0.39 to 0.63, P<0.000 01) and decreased levels of interleukin-6 (MD=?10.43, 95%CI ?14.91 to ?5.95, P<0.000 01), interleukin-1β (MD=?47.14, 95%CI ?63.92 to ?30.36, P<0.000 01), and tumor necrosis factor-α (MD=?9.13, 95%CI ?12.38 to ?5.89, P<0.000 01). In contrast, the visual analog scale score of the acupuncture treatment group (MD=?1.26, 95%CI ?2.06 to ?0.47, P=0.002) was better than that of the control group. No significant difference was found in the level of central nervous system-specific protein (S100β) (MD=?0.06, 95%CI ?0.13 to 0.01, P=0.12) between the two groups. Conclusion Acupuncture therapy can improve tumor-related cognitive function in patients. Its curative effect is better than that of non-acupuncture therapy; however, its ability to reduce S100β levels is not significantly different from that of non-acupuncture therapy. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： CHEN Daohong, NI Xixiu, ZHOU Ziyang, QI Wenchuan, ZHAO Ling. Acupuncture for the treatment of tumor-related cognitive dysfunction: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(11): 1265-1271. doi: 10.7507/1672-2531.202204143 Copy

1.	Boscher C, Joly F, Clarisse B, et al. Perceived cognitive impairment in breast cancer survivors and its relationships with psychological factors. Cancers (Basel), 2020, 12(10): 3000.
2.	Janelsins MC, Kohli S, Mohile SG, et al. An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol, 2011, 38(3): 431-438.
3.	林舜艷, 尹正錄, 高巨, 等. 針藥復合麻醉對老年患者術后早期認知功能障礙及炎性細胞因子TNF-α, IL-1β, IL-6的影響. 中國中西醫結合雜志, 2014, 34(7): 795-799.
4.	紀木火, 雷蕾, 楊建軍. 術后認知功能障礙研究現狀. 臨床麻醉學雜志, 2018, 34(9): 918-920.
5.	招彩彬. 針灸配合化療治療非小細胞肺癌的療效觀察. 臨床醫學研究與實踐, 2017, 2(17): 133-134.
6.	蔣垂剛, 農金梅. 針灸治療輕度認知功能障礙的臨床研究進展. 現代醫學與健康研究電子雜志, 2020, 4(5): 122-124.
7.	王舒, 錢宇斐, 樊小農, 等. 醒腦開竅針刺法主穴內關對腦缺血模型(MCAO)大鼠腦神經細胞壞死的抑制作用研究. 山西中醫, 2009, 25(8): 41-44.
8.	金紅姝, 霍麗, 郭小溪. 針刺“百會”穴對輕度認知功能障礙模型大鼠腦內S100β蛋白的影響. 遼寧中醫雜志, 2009, 36(4): 648-650.
9.	Wang N, Ou Y, Qing W. Combined acupuncture and general anesthesia on immune and cognitive function in elderly patients following subtotal gastrectomy for gastric cancer. Oncol Lett, 2018, 15(1): 189-194.
10.	Xi L, Fang F, Yuan H, et al. Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial. Trials, 2021, 22(1): 563.
11.	林舜艷, 尹正錄, 高巨, 等. 針刺麻醉對老年患者腸癌切除術后認知功能障礙影響及其S-100β蛋白的變化. 中國針灸, 2013, 33(1): 63-66.
12.	倪劍武, 蔣柳明, 周一敏, 等. 經皮穴位電刺激對老年患者腹腔鏡直腸癌切除術后認知功能的影響研究. 中國全科醫學, 2015, 18(12): 1390-1395.
13.	于洋, 鐘和, 英徐兵, 等. 針刺聯合全麻對老年患者腸癌切除術后認知功能的影響. 陜西中醫, 2016, 37(8): 1070-1071.
14.	劉智, 滕永杰. 針刺復合全麻對老年腫瘤切除術患者術后認知功能及相關炎癥因子的影響. 中國醫藥導報, 2017, 14(22): 76-79.
15.	唐屹, 卿明巨. 經皮穴位電刺激對老年結直腸癌患者術后認知功能的影響. 現代醫藥衛生, 2017, 33(23): 3623-3625.
16.	韓曉娜. 針刺聯合麻醉對老年患者腸癌切除術患者術后認知功能的影響. 黑龍江中醫藥, 2018, 47(1): 68-69.
17.	孫海燕, 紀金芬, 錢敏. BIS指導下針刺聯合全麻對老年胃癌根治術患者術后早期認知功能的影響. 臨床麻醉學雜志, 2018, 34(6): 599-601.
18.	張萃, 韓冬, 張玉, 等. 針刺益氣調神穴位治療乳腺癌患者化療所致輕度認知障礙的臨床研究. 中醫藥導報, 2018, 24(9): 49-52.
19.	張玉, 張萃, 徐曉華, 等. 調和氣血, 補心益智針刺法治療乳腺癌化療相關認知障礙氣血失調證患者53例臨床觀察. 中醫雜志, 2019, 60(6): 509-513.
20.	程國強, 樊風葉, 王志剛, 等. 針刺聯合丙泊酚全身麻醉用于老年胃腸道腫瘤切除術圍術期臨床觀察. 中國藥業, 2020, 29(14): 94-97.
21.	唐毅, 李玉娟, 陳亞, 等. 經皮穴位電刺激聯合全身麻醉對腹腔鏡結直腸癌根治術患者炎性因子, T細胞亞群和認知功能的影響. 現代生物醫學進展, 2020, 20(23): 4571-4575.
22.	楊海萍. 電針百會, 四神聰穴治療全腦放療認知功能障礙的臨床觀察. 上海針灸雜志, 2020, 39(3): 305-309.
23.	王倩楠, 張加強, 崔明珠, 等. 針藥平衡麻醉對老年婦科腫瘤術后早期認知功能及短期臨床預后的影響. 國際醫藥衛生導報, 2021, 27(17): 2655-2660.
24.	Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
25.	Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
26.	Kristek G, Rado? I, Kristek D, et al. Influence of postoperative analgesia on systemic inflammatory response and postoperative cognitive dysfunction after femoral fractures surgery: a randomized controlled trial. Reg Anesth Pain Med, 2019, 44(1): 59-68.
27.	彭五一, 王志濤, 劉德君, 等. 吸入, 靜脈全身麻醉方式對老年人術后認知功能障礙及復蘇質量的影響. 國際精神病學雜志, 2020, 47(3): 576-579.
28.	陳少仁, 高紅濤, 茹永剛, 等. 針刺百會, 內關穴治療血管性癡呆的臨床療效觀察. 四川中醫, 2007, (3): 98-100.
29.	周民濤, 張彩舉, 付金厚, 等. 電針對老年冠心病患者行胃癌根治術術后鎮痛與應激反應的影響. 上海針灸雜志, 2020, 39(8): 1027-1032.
30.	韓濟生. 針麻鎮痛研究. 針刺研究, 2016, 41(5): 377-387.
31.	Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci, 2003, 26(1): 17-22.
32.	祁愛花, 王愛忠. 丙泊酚與七氟烷對老年肺癌患者術后認知功能的影響. 醫學綜述, 2018, 24(3): 606-612, 616.

1. Boscher C, Joly F, Clarisse B, et al. Perceived cognitive impairment in breast cancer survivors and its relationships with psychological factors. Cancers (Basel), 2020, 12(10): 3000.
2. Janelsins MC, Kohli S, Mohile SG, et al. An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol, 2011, 38(3): 431-438.
3. 林舜艷, 尹正錄, 高巨, 等. 針藥復合麻醉對老年患者術后早期認知功能障礙及炎性細胞因子TNF-α, IL-1β, IL-6的影響. 中國中西醫結合雜志, 2014, 34(7): 795-799.
4. 紀木火, 雷蕾, 楊建軍. 術后認知功能障礙研究現狀. 臨床麻醉學雜志, 2018, 34(9): 918-920.
5. 招彩彬. 針灸配合化療治療非小細胞肺癌的療效觀察. 臨床醫學研究與實踐, 2017, 2(17): 133-134.
6. 蔣垂剛, 農金梅. 針灸治療輕度認知功能障礙的臨床研究進展. 現代醫學與健康研究電子雜志, 2020, 4(5): 122-124.
7. 王舒, 錢宇斐, 樊小農, 等. 醒腦開竅針刺法主穴內關對腦缺血模型(MCAO)大鼠腦神經細胞壞死的抑制作用研究. 山西中醫, 2009, 25(8): 41-44.
8. 金紅姝, 霍麗, 郭小溪. 針刺“百會”穴對輕度認知功能障礙模型大鼠腦內S100β蛋白的影響. 遼寧中醫雜志, 2009, 36(4): 648-650.
9. Wang N, Ou Y, Qing W. Combined acupuncture and general anesthesia on immune and cognitive function in elderly patients following subtotal gastrectomy for gastric cancer. Oncol Lett, 2018, 15(1): 189-194.
10. Xi L, Fang F, Yuan H, et al. Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial. Trials, 2021, 22(1): 563.
11. 林舜艷, 尹正錄, 高巨, 等. 針刺麻醉對老年患者腸癌切除術后認知功能障礙影響及其S-100β蛋白的變化. 中國針灸, 2013, 33(1): 63-66.
12. 倪劍武, 蔣柳明, 周一敏, 等. 經皮穴位電刺激對老年患者腹腔鏡直腸癌切除術后認知功能的影響研究. 中國全科醫學, 2015, 18(12): 1390-1395.
13. 于洋, 鐘和, 英徐兵, 等. 針刺聯合全麻對老年患者腸癌切除術后認知功能的影響. 陜西中醫, 2016, 37(8): 1070-1071.
14. 劉智, 滕永杰. 針刺復合全麻對老年腫瘤切除術患者術后認知功能及相關炎癥因子的影響. 中國醫藥導報, 2017, 14(22): 76-79.
15. 唐屹, 卿明巨. 經皮穴位電刺激對老年結直腸癌患者術后認知功能的影響. 現代醫藥衛生, 2017, 33(23): 3623-3625.
16. 韓曉娜. 針刺聯合麻醉對老年患者腸癌切除術患者術后認知功能的影響. 黑龍江中醫藥, 2018, 47(1): 68-69.
17. 孫海燕, 紀金芬, 錢敏. BIS指導下針刺聯合全麻對老年胃癌根治術患者術后早期認知功能的影響. 臨床麻醉學雜志, 2018, 34(6): 599-601.
18. 張萃, 韓冬, 張玉, 等. 針刺益氣調神穴位治療乳腺癌患者化療所致輕度認知障礙的臨床研究. 中醫藥導報, 2018, 24(9): 49-52.
19. 張玉, 張萃, 徐曉華, 等. 調和氣血, 補心益智針刺法治療乳腺癌化療相關認知障礙氣血失調證患者53例臨床觀察. 中醫雜志, 2019, 60(6): 509-513.
20. 程國強, 樊風葉, 王志剛, 等. 針刺聯合丙泊酚全身麻醉用于老年胃腸道腫瘤切除術圍術期臨床觀察. 中國藥業, 2020, 29(14): 94-97.
21. 唐毅, 李玉娟, 陳亞, 等. 經皮穴位電刺激聯合全身麻醉對腹腔鏡結直腸癌根治術患者炎性因子, T細胞亞群和認知功能的影響. 現代生物醫學進展, 2020, 20(23): 4571-4575.
22. 楊海萍. 電針百會, 四神聰穴治療全腦放療認知功能障礙的臨床觀察. 上海針灸雜志, 2020, 39(3): 305-309.
23. 王倩楠, 張加強, 崔明珠, 等. 針藥平衡麻醉對老年婦科腫瘤術后早期認知功能及短期臨床預后的影響. 國際醫藥衛生導報, 2021, 27(17): 2655-2660.
24. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
25. Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
26. Kristek G, Rado? I, Kristek D, et al. Influence of postoperative analgesia on systemic inflammatory response and postoperative cognitive dysfunction after femoral fractures surgery: a randomized controlled trial. Reg Anesth Pain Med, 2019, 44(1): 59-68.
27. 彭五一, 王志濤, 劉德君, 等. 吸入, 靜脈全身麻醉方式對老年人術后認知功能障礙及復蘇質量的影響. 國際精神病學雜志, 2020, 47(3): 576-579.
28. 陳少仁, 高紅濤, 茹永剛, 等. 針刺百會, 內關穴治療血管性癡呆的臨床療效觀察. 四川中醫, 2007, (3): 98-100.
29. 周民濤, 張彩舉, 付金厚, 等. 電針對老年冠心病患者行胃癌根治術術后鎮痛與應激反應的影響. 上海針灸雜志, 2020, 39(8): 1027-1032.
30. 韓濟生. 針麻鎮痛研究. 針刺研究, 2016, 41(5): 377-387.
31. Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci, 2003, 26(1): 17-22.
32. 祁愛花, 王愛忠. 丙泊酚與七氟烷對老年肺癌患者術后認知功能的影響. 醫學綜述, 2018, 24(3): 606-612, 616.

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Acupuncture for the treatment of tumor-related cognitive dysfunction: a meta-analysis

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