Systematic Evaluation Of Acupuncture Treatment Of Vascular Dementia

Background:Vascular dementia(Vascular dementia,VD)is a kind of clinical syndrome caused by cerebrovascular disease which related to the disability of intelligence and cognition.Its causes are diverse, including hypertension, family history, smoking and other factors.Western medicines are used as the main treatment to control the basic disseases and improve the cognitive function accompanied by rehabilitation.But the recovery effects vary from person to person.Acupuncture is often used as a method of rehabilitation for many cerebrovascular diseases,but there are no unified reports for its curative effect.Purpose:Evaluating the efficacy and safety of acupuncture treatment of vascular dementia by analyzing its RCT.Method:Computer retrieval of Chinese libraries includes:CNKI,CBM,VIP,Wanfang Database.Computer retrieval of Chinese libraries includes:PubMed,Cochrane Library, EMBASE.Manual searching the important acupuncture journals by 2015. Literatures were selected according to the diagnosis standard of VD,the inclusion and excluson criteria of this system evaluation.The data was analyzed by Revman5.3(include meta-analysis, qualitative analysis),the quality was graded by GRADE profller3.6.Result:Eleven literatures were incorporated.The scores of ADL,HDS improved obviously in the group of head needle plus body acupuncture,the results were graded as the MODERRATE.The rest of the groups were graded as LOW due to their insufficient sample size or other bias.The results indicated that acupuncture and moxibustion treatment for vascular dementia was superior to western medicine on curative effect. Head needle plus body acupuncture for vascular dementia was superior to western medicine on curative effect(RR 1.34,95%CI 1.16 to 1.56),intelligence improvement(MD 1.63,95%CI 1.31-1.94),life ability improvement(MD 2.26,95%CI 1.42-3.1 l),the nerve function(MD 4.32,95%CI 8.38-0.26),blood rheology(MD 1.44,95%CI 1.91-0.97) and Hcy(MD 6,95%CI 6.29-5.71).Body acupuncture therapy for VD was slightly better than western medicine on intelligence improvement(MD 1.46,95%CI 0.37-2.56),but lacked of statistical significance on curative effect(RR 1.11,95%CI 0.96-1.29)and life ability(MD 2.82,95%CI 0.43-6.06) improvement,the same as the head needle with auricular needle therapy group.Electroacupuncture therapy for VD acked of statistical significance on curative effect(RR 1.32,95%CI 0.97-1.79).Moxibustion treatment for vascular dementia was superior to western medicine on intelligence(MD 1.6,95%CI 0.13-3.07) and life ability improvement(MD 7,95%CI 0.2-13.8),but lacked of statistical significance on curative effect(RR 1.33,95%CI 0.95-1.88).The adverse reactions could't be evaluated because of the lack of statistical significance.Conclusion:Acupuncture for vascular dementia is superior to western medicine on curative effect,intelligence improvement,life ability improvement,especially the head needle plus body acupuncture method.The other treatment and adverse reactions need further analysis and evaluation.