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.	林舜艳, 尹正录, 高巨, 等. 针药复合麻醉对老年患者术后早期认知功能障碍及炎性细胞因子TNF-α, IL-1β, IL-6的影响. 中国中西医结合杂志, 2014, 34(7): 795-799.
4.	纪木火, 雷蕾, 杨建军. 术后认知功能障碍研究现状. 临床麻醉学杂志, 2018, 34(9): 918-920.
5.	招彩彬. 针灸配合化疗治疗非小细胞肺癌的疗效观察. 临床医学研究与实践, 2017, 2(17): 133-134.
6.	蒋垂刚, 农金梅. 针灸治疗轻度认知功能障碍的临床研究进展. 现代医学与健康研究电子杂志, 2020, 4(5): 122-124.
7.	王舒, 钱宇斐, 樊小农, 等. 醒脑开窍针刺法主穴内关对脑缺血模型(MCAO)大鼠脑神经细胞坏死的抑制作用研究. 山西中医, 2009, 25(8): 41-44.
8.	金红姝, 霍丽, 郭小溪. 针刺“百会”穴对轻度认知功能障碍模型大鼠脑内S100β蛋白的影响. 辽宁中医杂志, 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.	林舜艳, 尹正录, 高巨, 等. 针刺麻醉对老年患者肠癌切除术后认知功能障碍影响及其S-100β蛋白的变化. 中国针灸, 2013, 33(1): 63-66.
12.	倪剑武, 蒋柳明, 周一敏, 等. 经皮穴位电刺激对老年患者腹腔镜直肠癌切除术后认知功能的影响研究. 中国全科医学, 2015, 18(12): 1390-1395.
13.	于洋, 钟和, 英徐兵, 等. 针刺联合全麻对老年患者肠癌切除术后认知功能的影响. 陕西中医, 2016, 37(8): 1070-1071.
14.	刘智, 滕永杰. 针刺复合全麻对老年肿瘤切除术患者术后认知功能及相关炎症因子的影响. 中国医药导报, 2017, 14(22): 76-79.
15.	唐屹, 卿明巨. 经皮穴位电刺激对老年结直肠癌患者术后认知功能的影响. 现代医药卫生, 2017, 33(23): 3623-3625.
16.	韩晓娜. 针刺联合麻醉对老年患者肠癌切除术患者术后认知功能的影响. 黑龙江中医药, 2018, 47(1): 68-69.
17.	孙海燕, 纪金芬, 钱敏. BIS指导下针刺联合全麻对老年胃癌根治术患者术后早期认知功能的影响. 临床麻醉学杂志, 2018, 34(6): 599-601.
18.	张萃, 韩冬, 张玉, 等. 针刺益气调神穴位治疗乳腺癌患者化疗所致轻度认知障碍的临床研究. 中医药导报, 2018, 24(9): 49-52.
19.	张玉, 张萃, 徐晓华, 等. 调和气血, 补心益智针刺法治疗乳腺癌化疗相关认知障碍气血失调证患者53例临床观察. 中医杂志, 2019, 60(6): 509-513.
20.	程国强, 樊风叶, 王志刚, 等. 针刺联合丙泊酚全身麻醉用于老年胃肠道肿瘤切除术围术期临床观察. 中国药业, 2020, 29(14): 94-97.
21.	唐毅, 李玉娟, 陈亚, 等. 经皮穴位电刺激联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子, T细胞亚群和认知功能的影响. 现代生物医学进展, 2020, 20(23): 4571-4575.
22.	杨海萍. 电针百会, 四神聪穴治疗全脑放疗认知功能障碍的临床观察. 上海针灸杂志, 2020, 39(3): 305-309.
23.	王倩楠, 张加强, 崔明珠, 等. 针药平衡麻醉对老年妇科肿瘤术后早期认知功能及短期临床预后的影响. 国际医药卫生导报, 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, Radoš 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, 王志涛, 刘德君, 等. 吸入, 静脉全身麻醉方式对老年人术后认知功能障碍及复苏质量的影响. 国际精神病学杂志, 2020, 47(3): 576-579.
28.	陈少仁, 高红涛, 茹永刚, 等. 针刺百会, 内关穴治疗血管性痴呆的临床疗效观察. 四川中医, 2007, (3): 98-100.
29.	周民涛, 张彩举, 付金厚, 等. 电针对老年冠心病患者行胃癌根治术术后镇痛与应激反应的影响. 上海针灸杂志, 2020, 39(8): 1027-1032.
30.	韩济生. 针麻镇痛研究. 针刺研究, 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.	祁爱花, 王爱忠. 丙泊酚与七氟烷对老年肺癌患者术后认知功能的影响. 医学综述, 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. 林舜艳, 尹正录, 高巨, 等. 针药复合麻醉对老年患者术后早期认知功能障碍及炎性细胞因子TNF-α, IL-1β, IL-6的影响. 中国中西医结合杂志, 2014, 34(7): 795-799.
4. 纪木火, 雷蕾, 杨建军. 术后认知功能障碍研究现状. 临床麻醉学杂志, 2018, 34(9): 918-920.
5. 招彩彬. 针灸配合化疗治疗非小细胞肺癌的疗效观察. 临床医学研究与实践, 2017, 2(17): 133-134.
6. 蒋垂刚, 农金梅. 针灸治疗轻度认知功能障碍的临床研究进展. 现代医学与健康研究电子杂志, 2020, 4(5): 122-124.
7. 王舒, 钱宇斐, 樊小农, 等. 醒脑开窍针刺法主穴内关对脑缺血模型(MCAO)大鼠脑神经细胞坏死的抑制作用研究. 山西中医, 2009, 25(8): 41-44.
8. 金红姝, 霍丽, 郭小溪. 针刺“百会”穴对轻度认知功能障碍模型大鼠脑内S100β蛋白的影响. 辽宁中医杂志, 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. 林舜艳, 尹正录, 高巨, 等. 针刺麻醉对老年患者肠癌切除术后认知功能障碍影响及其S-100β蛋白的变化. 中国针灸, 2013, 33(1): 63-66.
12. 倪剑武, 蒋柳明, 周一敏, 等. 经皮穴位电刺激对老年患者腹腔镜直肠癌切除术后认知功能的影响研究. 中国全科医学, 2015, 18(12): 1390-1395.
13. 于洋, 钟和, 英徐兵, 等. 针刺联合全麻对老年患者肠癌切除术后认知功能的影响. 陕西中医, 2016, 37(8): 1070-1071.
14. 刘智, 滕永杰. 针刺复合全麻对老年肿瘤切除术患者术后认知功能及相关炎症因子的影响. 中国医药导报, 2017, 14(22): 76-79.
15. 唐屹, 卿明巨. 经皮穴位电刺激对老年结直肠癌患者术后认知功能的影响. 现代医药卫生, 2017, 33(23): 3623-3625.
16. 韩晓娜. 针刺联合麻醉对老年患者肠癌切除术患者术后认知功能的影响. 黑龙江中医药, 2018, 47(1): 68-69.
17. 孙海燕, 纪金芬, 钱敏. BIS指导下针刺联合全麻对老年胃癌根治术患者术后早期认知功能的影响. 临床麻醉学杂志, 2018, 34(6): 599-601.
18. 张萃, 韩冬, 张玉, 等. 针刺益气调神穴位治疗乳腺癌患者化疗所致轻度认知障碍的临床研究. 中医药导报, 2018, 24(9): 49-52.
19. 张玉, 张萃, 徐晓华, 等. 调和气血, 补心益智针刺法治疗乳腺癌化疗相关认知障碍气血失调证患者53例临床观察. 中医杂志, 2019, 60(6): 509-513.
20. 程国强, 樊风叶, 王志刚, 等. 针刺联合丙泊酚全身麻醉用于老年胃肠道肿瘤切除术围术期临床观察. 中国药业, 2020, 29(14): 94-97.
21. 唐毅, 李玉娟, 陈亚, 等. 经皮穴位电刺激联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子, T细胞亚群和认知功能的影响. 现代生物医学进展, 2020, 20(23): 4571-4575.
22. 杨海萍. 电针百会, 四神聪穴治疗全脑放疗认知功能障碍的临床观察. 上海针灸杂志, 2020, 39(3): 305-309.
23. 王倩楠, 张加强, 崔明珠, 等. 针药平衡麻醉对老年妇科肿瘤术后早期认知功能及短期临床预后的影响. 国际医药卫生导报, 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, Radoš 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, 王志涛, 刘德君, 等. 吸入, 静脉全身麻醉方式对老年人术后认知功能障碍及复苏质量的影响. 国际精神病学杂志, 2020, 47(3): 576-579.
28. 陈少仁, 高红涛, 茹永刚, 等. 针刺百会, 内关穴治疗血管性痴呆的临床疗效观察. 四川中医, 2007, (3): 98-100.
29. 周民涛, 张彩举, 付金厚, 等. 电针对老年冠心病患者行胃癌根治术术后镇痛与应激反应的影响. 上海针灸杂志, 2020, 39(8): 1027-1032.
30. 韩济生. 针麻镇痛研究. 针刺研究, 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. 祁爱花, 王爱忠. 丙泊酚与七氟烷对老年肺癌患者术后认知功能的影响. 医学综述, 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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