Effect of Acupuncture on Cognitive Function of Insomnia Patients Compared with Drugs: A Protocol for Meta-analysis and Systematic Review.
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ABSTRACT:
SUBMITTER: Qin S
PROVIDER: S-EPMC8452430 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Warm needle acupuncture (WNA) combines acupuncture and moxibustion, which is an integral part of the acupuncture therapy. Insomnia is a common sleep disorder, which affects sub-healthy people and patients with chronic disease. The clinical practice indicates that WNA has a therapeutic effect on insomnia. Here we will provide a protocol to explore the effectiveness and safety of WNA for insomnia. METHODS:We will search the randomized controlled trails (RCT) literatures of WNA for insomnia in 9 electronic databases, including 5 English databases [PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane Library), and WHO International Clinical Trials Registry Platform (TCTRP)] and 4 Chinese databases [Chinese National Knowledge Infrastructure (CNKI), Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database (CBM)]. Sleep quality value of the patient will be considered as the primary outcome and the secondary outcome will include biochemical, indicators total scores on the insomnia severity index, quality of life, adverse events caused by WNA, and changes of symptom in Traditional Chinese Medicine. The selection of the studies will be performed by EndnoteX7 software. All analyses will be conducted by using RevMan software V5.3. RESULT:This study will provide a rational synthesis of current evidences for warm needle acupuncture on insomnia. CONCLUSION:The conclusion of this study will provide evidence to judge the effectiveness and safety of WNA on insomnia. REGISTRATION:PROS-PERO CRD42018112645.
| S-EPMC6319996 | biostudies-other
Project description:IntroductionThis systematic review and meta-analysis aimed to assess the efficacy of acupuncture or moxibustion therapy in senile insomnia patients.MethodsA comprehensive literature search was conducted using 7 electronic databases to identify randomized controlled trials reported on the use of acupuncture or moxibustion therapy in insomnia. The time frame was set from database establishment to March 11, 2023. The RevMan (version 5.3) and STATA (version 17.0) software were used to evaluate the quality of the included randomized controlled trials and perform a meta-analysis. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Subgroup analysis was performed based on different intervention methods. The I2 statistic was used to assess heterogeneity among studies.ResultsA total of 20 studies conducted between 2007 and 2022 were included, involving 1677 patients with senile insomnia. In terms of efficacy, acupuncture or moxibustion alone was significantly better than western drugs (RR = 1.12; 95% CI, 1.06-1.20), acupuncture combined with drugs was better than drugs alone (RR = 1.20; 95% CI, 1.12-1.29), and acupuncture combined with cognitive behavior therapy intervention (CBT-I) was significantly better than CBT-I alone (RR = 1.52; 95% CI, 1.07-2.17). In terms of Pittsburgh Sleep Quality Index scores, acupuncture or moxibustion alone was more effective than western drugs (MD = -1.82; 95% CI, -2.37 to -1.26), acupuncture combined with drugs was more effective than drugs alone (MD = -3.10; 95% CI, -4.25 to -1.95), and acupuncture was significantly more effective than sham acupuncture (MD = -4.18; 95% CI, -5.85 to -2.51) and psychological intervention (MD = -3.54; 95% CI, -4.33 to -2.75) in improving sleep quality.ConclusionsThis meta-analysis revealed that acupuncture or moxibustion alone or combination with other therapies(drugs, CBT-I or psychological intervention) has high clinical efficacy and can improve the sleep quality of patients with senile insomnia. However, further well-designed studies are warranted to verify these findings.
| S-EPMC10589601 | biostudies-literature
Project description:There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review available that would enable providers and patients to make informed choices regarding this important aspect of treatment. With a large number of substances available, conventional pairwise meta-analyses will not be sufficient to inform this choice. To fill this gap, we will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomized controlled trials (RCTs) to rank antipsychotics according to their effect on cognitive functioning. In our NMA, we will include RCTs in patients with schizophrenia or schizophrenia-like psychoses comparing one antipsychotic agent with another antipsychotic agent or placebo that measures cognitive function. We will include studies on patients of every age group, in any phase of illness (e.g., acute or stable, first episode or chronic schizophrenia, in- or outpatients) with an intervention time of at least 3 weeks. The primary outcome will be the composite score of cognitive functioning, preferentially measured with the test battery developed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. The secondary outcomes include the seven cognitive domains that the composite score is composed of, as well as functioning and quality of life. Study selection and data extraction will be conducted by at least two independent reviewers. We will use the Cochrane Risk of Bias tool 2 to determine the risk of bias in studies, and we will evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). We will perform NMA using R (package netmeta). We will conduct subgroup and sensitivity analyses to explore the heterogeneity and assess the robustness of our findings. This systematic review and network meta-analysis aims to inform evidence-based antipsychotic treatment choice for cognitive deficits in schizophrenia patients by analyzing existing RCTs on this subject. The results have the potential to support patients' and physicians' decision-making processes based on the latest available evidence. PROSPERO CRD42022312483.
| S-EPMC10037873 | biostudies-literature
Project description:Objectives. Acupuncture has been widely used to relieve chronic pain-related insomnia (CPRI). However, the efficacy of acupuncture for CPRI is uncertain. The purpose of this study was to evaluate the efficacy of acupuncture for CPRI. Methods. Seven electronic databases were searched from inception to December 2018. Randomized controlled trials (RCTs) were included if acupuncture was compared to sham acupuncture or conventional drug therapies for treating CPRI. Two reviewers screened each study and extracted data independently. Statistical analyses were conducted by RevMan 5.3 software. Results. A total of nine studies involving 944 patients were enrolled. The pooled analysis indicated that acupuncture treatment was significantly better than control group in improving effective rate (OR = 8.09, 95%CI = [4.75, 13.79], P < 0.00001) and cure rate (OR = 3.17, 95%CI = [2.35, 4.29], P < 0.00001), but subgroup analysis showed that there was no statistically significant difference between acupuncture and sham acupuncture in improving cure rate (OR =10.36, 95% CI [0.53, 201.45], P=0.12) based on one included study. In addition, meta-analysis demonstrated that acupuncture group was superior to control group in debasing PSQI score (MD = -2.65, 95%CI = [-4.00, -1.30], P = 0.0001) and VAS score (MD = -1.44, 95%CI = [-1.58, -1.29], P < 0.00001). And there was no significant difference in adverse events (OR =1.73, 95%CI = [0.92, 3.25], P =0.09) between the two groups. Conclusions. Acupuncture therapy is an effective and safe treatment for CPRI, and this treatment can be recommended for the management of patients with CPRI. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large sample size are recommended in future.
| S-EPMC6612974 | biostudies-literature
Project description:BACKGROUND:Hyperlipidemia is a major risk factor for cardiovascular and cerebrovascular diseases. Acupuncture has been widely applied in the treatment of hyperlipidemia. But its efficacy has not been evaluated scientifically and systematically. Therefore, we provide a protocol of systematic evaluation to assess the effectiveness and safety of acupuncture treatment on patient with hyperlipidemia. METHODS:We will search the following databases electronically, including 3 English literature databases (i.e., PubMed, Embase, and Cochrane Library) and 4 Chinese literature databases (i.e., Chinese Biological and Medical database, China National Knowledge Infrastructure, VIP, and Wanfang Database). We will also search randomized-controlled trials about acupuncture treatment for hyperlipidemia and the search time limit is from its establishment to October 2018. The primary outcome is lipid-lowering efficacy. Secondary outcomes are total cholesterol, low-density lipoprotein cholesterol, triglyceride, and high-density lipoprotein cholesterol levels. We will use RevMan V.5.3 software as well to compute the data synthesis carefully when a meta-analysis is allowed. RESULTS:This study will provide a high-quality synthesis to assess the effectiveness and safety of acupuncture treatment on patient with hyperlipidemia. CONCLUSION:The conclusion of our systematic review will provide evidence to judge whether acupuncture is an effective intervention for patient with hyperlipidemia.
| S-EPMC6319778 | biostudies-other
Project description:Introduction Cancer-related insomnia (CRI), as a common complication in cancer survivors, may further lead to depression, anxiety and other symptoms. Acupuncture therapy is a promising therapeutic strategy for CRI. The effectiveness of acupuncture therapy on CRI has been validated by several relevant meta-analyses. Questions remain, however, including which acupuncture regimen is optimal. We aim to conduct the first network meta-analysis to compare different acupuncture therapies, rank their effectiveness and assess which approach could be optimal for treatment of CRI. Methods and analysis A comprehensive search of PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Database, VIP Database (China Science and Technology Journal Database), and China Biology Medicine (from inception until 1 March 2022) will be carried out to identify randomised controlled trials (RCTs) of acupuncture therapy for insomnia in cancer survivors, reported in English or Chinese. Reviews, animal studies, non-RCT studies, editorials and other secondary insomnia studies will be excluded. The primary outcome measure will be the Pittsburgh Sleep Quality Index. Pairwise meta-analysis will be performed in Stata and network meta-analysis by OpenBUGS, R and Stata. Network plots and funnel plots will be used to show the scale of studies and participants for each intervention and the potential publication bias, respectively. Both heterogeneity and consistency will be evaluated by R. ORs with 95% CIs and mean differences with 95% CI will be calculated in OpenBUGS and transformed into league figure and surface under the cumulative ranking by Stata to visualise the results. Ethics and dissemination Ethical committee approval for this review is unnecessary since the data used will be extracted from pre-existing literature. The results will be submitted for publication in a peer-reviewed journal and presented at international academic conferences.
| S-EPMC9743408 | biostudies-literature
Project description:BackgroundA considerable number of stroke survivors suffered from cognitive impairment, and more than one third of stroke survivors are affected at 3 and 12 months after the stroke. Although the published systematic reviews suggest that acupuncture can help improve post-stroke cognitive dysfunction, the power of the results is low due to study limitations. Therefore, this review is necessary to analyze the effect of acupuncture on cognitive impairment after stroke and to provide evidence for cognitive impairment in stroke.MethodsThis study will be carried out in strict accordance with the Cochrane Handbook for Systematic Reviews of Interventions. According to the pre-established search strategy (PICOS framework), all the literature will be obtained from online databases including Cochrane Central Register of Controlled Trials in the Cochrane Library, Medline (via PubMed), EMBASE (via embase.com), CINAHL (via EBSCOhost), China National Knowledge Infrastructure database, WanFang Database, Chinese Science and Technology Periodical Database, and Sino-Med Database from inception until December 31, 2021 with no language limitations. Two reviewers will screen the records and include quality studies according to inclusion criteria independently. The data needed will be extracted independently by 2 authors according to a table of data extraction. Any inconsistencies in literature screening and data collection will be resolved to reach a consensus via discussion with a third author. Risk of bias for each study will be assessed using risk of bias tool. RevMan5.3 will be used to analyze the data. Heterogeneity will be identified and measured by Chi2. Subgroup analyses and sensitivity analysis will be carried out. Grading of Recommendations Assessment, Development and Evaluation will be used to evaluate the evidence for each outcome.ConclusionThe results of this study will provide a theoretical basis for the clinical use of electro-acupuncture to treat cognitive dysfunction after stroke.Unique inplasy numberINPLASY202210038.
| S-EPMC8878786 | biostudies-literature
Project description:BACKGROUND:Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. Relevant management is expected to prevent MCI patients from progressing to dementia. In recent years, electroacupuncture (EA) has been used to treat various kinds of neurological disorders including MCI. This study evaluates the use of EA for MCI patients to increase cognitive function through a comparison with Western medications. METHODS:Randomized controlled trials (RCT) or systematical reviews (SR) of EA versus Western medications for MCI were searched using the following 10 databases: Pubmed, Cochrane Library, CINAHL, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Journal of Oriental Neuropsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS, from October 2007 to August 2017, without language restriction. A methodological quality assessment of RCTs or SRs that met inclusion criteria was conducted using Cochrane Risk of bias (RoB) tool and a meta-analysis by RevMan (Review Manager) 5.3.5 version of Cochrane collaboration. RESULTS:Five RCTs with 257 patients met inclusion criteria and those were randomly divided into two groups: the EA group (n?=?103) and Western medications group (n?=?154). The methodological quality of the included studies showed high risk or/and unclear of risk of bias. The meta-analysis of five studies reported that the EA group was better than the Western medications group, improving the Mini Mental State Examination (MMSE) score by 0.65 [95% CI 0.28~1.01] higher mean difference, Montreal Cognitive Assessment (MoCA) score by 0.66 [95% CI 0.00~1.32] higher mean difference. Adverse effects were not reported in the selected studies. CONCLUSION:Electroacupuncture was an effective treatment for MCI patients by improving cognitive function. However, the included studies presented a low methodological quality and no adverse effects were reported. Thus, further comprehensive studies with a design in depth are needed to derive significant results.
| S-EPMC6325879 | biostudies-other
Project description:BackgroundHypnotic drugs tend to be the dominant form of treatment of insomnia, but these come with a number of reported side effects. Acupuncture has been studied as an alternative, resulting in a rising need for methodological research towards verifying its efficacy as insomnia treatment.Methods/designWe describe a proposal for a single-center, patient-assessor-blinded, randomized controlled trial with two parallel arms. A total of 38 patients complete screening tests at the first visit, are registered into the clinical trial, and then randomly assigned to the experimental or sham control groups (19 patients for each group). All subjects are clinical insomnia patients who score a 6 or above on the Pittsburgh Sleep Quality Index (PSQI) and meet all inclusion criteria. All subjects are treated with acupuncture and intradermal acupuncture (IDA) three times during the first week. Five sham acupoints are used in the control group. In the experimental group, five real acupoints (PC6, SP6, HT7, KI6, and BL62) are used unilaterally in turn. Sham acupoints are over 1 cm away from each real acupoint.The primary outcomes are the scores on the Insomnia Severity Index (ISI) and PSQI. Secondary outcomes are the sleep log, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF), the Korean-Auditory Verbal Learning Test (K-AVLT), the Digit Span Test (DS), Event Related Potentials (ERPs) and heart rate variability (HRV) to assess emotional states, sleep quality, cognitive functioning, and electro-physiological changes.Subjects are assessed at three time points: baseline, post-treatment and follow-up. The duration of the clinical trial is 18 days.DiscussionTo study the enhancement of the effectiveness of acupuncture for insomnia, we test the intradermal acupuncture method, which is performed continuously on the subject's skin and stimulated at home by the subject every night. In the trial, objective measurements including ERPs and HRV are used to evaluate states of cognition and autonomic nervous system functioning and subjective self-report questionnaires assess insomnia symptoms.'Sham' acupuncture points provided by STRICTA are used for the control group.Trial registrationClinicalTrials.gov: NCT01956760, registered 5 September 2013.
| S-EPMC4213556 | biostudies-literature
Project description:Introduction Coronavirus Disease 2019 (COVID-19) has made a serious public health threat worldwide. Recent evidence has indicated that COVID-19 patients in convalescence frequently experience insomnia, which reduces their quality of life and causes unknown risks. The positive effect of cognitive behavior on insomnia has been well addressed in previous studies. Given the high infectivity and epidemicity of COVID-19, Internet-delivered intervention may be safer than face-to-face treatment. However, whether Internet-delivered cognitive behavioral therapy can effectively improve the insomnia of COVID-19 patients in convalescence has not been completely determined yet. Therefore, we conducted a meta-analysis and systematic review to evaluate the effects of Internet-delivered cognitive behavioral therapy on insomnia in COVID-19 patients in convalescence, with the aim to confer some guidance for its clinical application. Methods and analysis This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Two researchers will retrieve the relevant literature on Internet-delivered cognitive behavioral therapy for insomnia in convalescent patients with COVID-19 in PubMed, Web of Science, Embase, MEDLINE, Cochrane Library, Clinical Trials gov, Chinese Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure (CNKI) from inception to 11th of December. In addition, we will review the relevant trials and references of the included literature and manually searched the grey literature. The two researchers will independently extracted data and information and evaluated the quality of the included literature. The Review Manager software (version 5.3) and Stata software (version 14.0) will be used for data analysis. The mean difference or the standardized mean difference of 95% CI will be used to calculate continuous variables to synthesize the data. In addition, I2 and Cochrane will be used for heterogeneity assessment. Trial registration PROSPERO registration number CRD42021271278.
| S-EPMC9197064 | biostudies-literature