Acupuncture has shown
the much better improvement in cognitive function than donepezil in patients
with mild to moderate form of Alzheimer’s disease in a 24-week clinical trial.
The study was published in the journal of BMC Complementary and Alternative
Medicine.
Alzheimer’s disease
(AD) is characterized by memory impairment and personality changes and is the
most common type of dementia. The conditions lead to a loss of personal
independence which has wide range of impact on the individual, families and
societies; as it is predicted that the prevalence of AD will rise exponentially
in elderly people from 1% at age of 65 to approximately 40-50% by the age of
95. So far the medications used to treat AD include cholinesterase-inhibitors
such as donepezil which offers only modest symptomatic relief, but produced significantly
higher rates of adverse effects and discontinuation of treatment. So,
alternative treatment for the condition is urgently needed. Acupuncture has
been used to alleviate some symptoms of AD in China for a long time.
Recently a
randomized, drug-controlled, parallel group clinical study was conducted to
determine the efficacy and safety of acupuncture compared with donepezil in
patients with mild to moderate AD. Eighty seven patients qualified to the study
were randomly allocated into two groups: acupuncture group (AG, n=43) and drug
group (donepezil, DG, n=44).
The primary outcome
measures included (1) Alzheimer's Disease Assessment Scale-Cog (ADAS-cog). (2) Clinician
Interview-Based Impression of Change plus caregiver input (CIBIC-Plus). The
second outcome measures were (1) Activities of Daily Living Inventory (ADAS-ADL23).
(2) The Neuropsychiatric Inventory–Questionnaire (NPI). Those measures were
performed at the baseline, 12-week treatment period, and 12-week follow-up
period respectively.
Basic acupuncture acupoints
included RN17 (danzhong), RN12 (zhongwan), RN6 (qihai), ST36 (zusanli), SJ5 (waiguan)
and SP10 (xuehai). Complementary acupoints: LR3 (taichong), GB39 (xuanzhong),
ST40 (fenglong), BL17 (geshu), ST44 (neiting), ST25 (tianshu) and RN4 (guan
yuan), could be selected as auxiliary acupoints according to patient’s symptoms
and tongue manifestation. The needles were retained in situ for 30 min each
time. Acupuncture treatment was given three times weekly for 12 weeks. The
patients in the DG group received 5 mg/day of donepezil hydrochloride for the
first 4 weeks and then, 10 mg/day for 8 weeks.
The results shown
that acupuncture treatment statistically significantly improved cognitive
function, global clinical status compared with donepezil according to the
scores of ADAS-cog, CIBIC-Plus both at the end of 12-week treatment and 12-week
follow-up period. However, there was no significant difference in the
activities of daily living and behavioral symptoms based on the scores of
ADCSADL23 and NPI between AG and DG groups. Further, In the AG group, 5 cases
of insomnia, 4 cases of constipation, 6 elderly male cases with benign prostate
hyperplasia and 2 cases of knee arthritis reported that their symptoms were clearly
improved. However, patients in the DG group did not show any equivalent
improvements.
During the trial, 4
patients (9.3%) in AG experienced punctuate hemorrhage after the needles were
taken out, and 1patient (2.3%) had bruising. No serious adverse effects were
reported and no patients withdrew from the AG. Seven patients (15.9%) in DG reported
some adverse effects, including dizziness, nausea, loss of appetite, diarrhea, constipation;
fatigue and agitation. 4 of 7 cases (9.09%) withdrew from the trial.
The study showed that
acupuncture treatment could significantly improve cognitive function, global
clinical status in patients with mild to moderate AD, compared with donepezil, with less adverse effects.
Reference
Jia Y, Zhang X, Yu J,
Han J, Yu T, Shi J, Zhao L, Nie K., Acupuncture for patients with mild to
moderate Alzheimer's disease: a randomized controlled trial. BMC Complement
Altern Med. 2017 Dec 29;17(1):556. https://www.ncbi.nlm.nih.gov/pubmed/29284465
