针刺对血管性痴呆动物模型氧化应激的影响：系统评价和荟萃分析。
The effect of acupuncture on oxidative stress in animal models of vascular dementia: a systematic review and meta-analysis.
机构信息
Department of Traditional Chinese Medicine, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China.
The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
出版信息
Syst Rev. 2024 Feb 8;13(1):59. doi: 10.1186/s13643-024-02463-x.
BACKGROUND
Growing evidence showed that acupuncture may improve cognitive function by reducing oxidative stress, key to the pathogenesis in vascular dementia (VaD), but this is yet to be systematically analysed. This study aimed to summarize and evaluate the effect of acupuncture on oxidative stress in animal models of VaD.
METHOD
Eight databases including PubMed, Embase, Web of Science, Cochrane library, CNKI, Wan Fang, CBM, and VIP were searched since their establishment until April 2023, for studies that reported the effect of acupuncture on oxidative stress in VaD animal models. Relevant literature was screened, and information was extracted by two reviewers. The primary outcomes were the levels of oxidative stress indicators. The methodological quality was assessed via the SYRCLE Risk of Bias Tool. Statistical analyses were performed using the RevMan and Stata software.
RESULTS
In total, 22 studies with 747 animals were included. The methodology of most studies had flaws or uncertainties. The meta-analysis indicated that, overall, acupuncture significantly reduced the expression of pro-oxidants including reactive oxygen species (standardized mean differences [SMDs] = -4.29, 95% confidence interval [CI]: -6.26, -2.31), malondialdehyde (SMD = -2.27, 95% CI: -3.07, -1.47), nitric oxide (SMD = -0.85, 95% CI: -1.50, -0.20), and nitric oxide synthase (SMD = -1.01, 95% CI: -1.69, -0.34) and enhanced the levels of anti-oxidants including super oxide dismutase (SMD = 2.80, 95% CI: 1.98, 3.61), glutathione peroxidase (SMD = 1.32, 95% CI: -0.11, 2.76), and catalase (SMD = 1.31, 95% CI: 0.05, 2.58) in VaD animal models. In subgroup analyses, acupuncture showed significant effects on most variables. Only partial modelling methods and treatment duration could interpret the heterogeneity of some outcomes.
CONCLUSION
Acupuncture may inhibit oxidative stress to improve cognitive deficits in animal models of VaD. Nevertheless, the methodological quality is unsatisfactory. More high-quality research with a rigorous design and further experimental researches and clinical trials are needed to confirm these findings.
SYSTEMATIC REVIEW REGISTRATION
This study was registered in PROSPERO (CRD42023411720).
背景
越来越多的证据表明，针灸通过降低氧化应激来改善认知功能，这是血管性痴呆（VaD）发病机制的关键，但这尚未得到系统分析。本研究旨在总结和评估针灸对 VaD 动物模型氧化应激的影响。
方法
自建立以来至 2023 年 4 月，我们检索了 8 个数据库，包括 PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网、万方、中国生物医学文献数据库和维普，以检索报告针灸对 VaD 动物模型氧化应激影响的研究。由两位评审员筛选相关文献并提取信息。主要结局指标是氧化应激指标的水平。使用 SYRCLE 偏倚风险工具评估方法学质量。使用 RevMan 和 Stata 软件进行统计分析。
结果
共纳入 22 项研究，涉及 747 只动物。大多数研究的方法学存在缺陷或不确定性。Meta 分析表明，总体而言，针灸显著降低了促氧化剂的表达，包括活性氧（标准化均数差 [SMD] = -4.29，95%置信区间 [CI]：-6.26，-2.31）、丙二醛（SMD = -2.27，95% CI：-3.07，-1.47）、一氧化氮（SMD = -0.85，95% CI：-1.50，-0.20）和一氧化氮合酶（SMD = -1.01，95% CI：-1.69，-0.34），并提高了抗氧化剂的水平，包括超氧化物歧化酶（SMD = 2.80，95% CI：1.98，3.61）、谷胱甘肽过氧化物酶（SMD = 1.32，95% CI：-0.11，2.76）和过氧化氢酶（SMD = 1.31，95% CI：0.05，2.58）在 VaD 动物模型中。亚组分析显示，针灸对大多数变量均有显著影响。只有部分建模方法和治疗持续时间可以解释部分结果的异质性。
结论
针灸可能通过抑制氧化应激来改善 VaD 动物模型的认知缺陷。然而，其方法学质量并不令人满意。需要更多高质量的研究，设计严谨，并进行进一步的实验研究和临床试验，以证实这些发现。
系统评价注册
本研究已在 PROSPERO（CRD42023411720）上注册。
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