Efficacy and safety of hyperbaric oxygen therapy for vascular cognitive impairment: a meta-analysis_West China Medical Journal

Authors：

LIU Wenxiu ¹ , WANG Ming ² , PENG Xiaoling ³ ,  ZENG Xianrong ^1,3

1. School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
2. Department of Intensive Care Unit, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;
3. Hyperbaric Oxygen Therapy Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

ZENG Xianrong, Email: 570574804@qq.com

Keywords：

Vascular cognitive impairment; hyperbaric oxygen; randomized controlled trials; meta-analysis

DOI：

10.7507/1002-0179.202111008

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To conduct a meta-analysis of the evidence on the efficacy and safety of hyperbaric oxygen therapy for vascular cognitive impairment. Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Embase, CINHAL, Cochrance Library were searched for all literatures on randomized controlled trials of hyperbaric oxygen therapy for vascular cognitive impairment from the establishment of databases to May 2022. Literature screening was performed by Endnote X9 software, and meta-analysis was performed by RevMan 5.4.1 software. Results A total of 36 papers were included, with 3093 patients, including 1549 cases in the observation group (hyperbaric oxygen combined with drug treatment) and 1544 cases in the control group (drug treatment alone). Compared with the control group, the effective rate of the observation group [relative risk=1.23, 95% confidence interval (CI) (1.15, 1.30), P<0.00001], the scores of Mini Mental Status Examination [mean difference (MD)=3.19, 95%CI (2.66, 3.73), P<0.00001], and the scores of Montreal Cognitive Assessment [MD=2.98, 95%CI (2.07, 3.89), P<0.00001] were better than those of the control group. There was no significant difference in adverse reactions between the observation group and the control group (P>0.05). For the scores of Activities of Daily Living, subgroup analysis showed high heterogeneity among studies, so pooled analysis was not performed. Conclusion Compared with drug therapy alone, hyperbaric oxygen combined with drug therapy can improve the cognitive function of patients with vascular cognitive impairment to a certain extent without increasing adverse reactions.

Citation： LIU Wenxiu, WANG Ming, PENG Xiaoling, ZENG Xianrong. Efficacy and safety of hyperbaric oxygen therapy for vascular cognitive impairment: a meta-analysis. West China Medical Journal, 2022, 37(6): 863-874. doi: 10.7507/1002-0179.202111008 Copy

1.	中國醫師協會神經內科分會認知障礙專業委員會, 《中國血管性認知障礙診治指南》編寫組. 2019 年中國血管性認知障礙診治指南. 中華醫學雜志, 2019, 99(35): 2737-2744.
2.	O’Brien JT, Wiseman R, Burton EJ, et al. Cognitive associations of subcortical white matter lesions in older people. Ann N Y Acad Sci, 2002, 977: 436-444.
3.	Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2011, 42(9): 2672-2713.
4.	Skrobot OA, Black SE, Chen C, et al. Progress toward standardized diagnosis of vascular cognitive impairment: guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimers Dement, 2018, 14(3): 280-292.
5.	Shah H, Albanese E, Duggan C, et al. Research priorities to reduce the global burden of dementia by 2025. Lancet Neurol, 2016, 15(12): 1285-1294.
6.	Larsson SC, Markus HS. Does treating vascular risk factors prevent dementia and Alzheimer’s disease? A systematic review and meta-analysis. J Alzheimers Dis, 2018, 64(2): 657-668.
7.	Smith EE, Barber P, Field TS, et al. Canadian consensus conference on diagnosis and treatment of dementia (CCCDTD)5: guidelines for management of vascular cognitive impairment. Alzheimers Dement (N Y), 2020, 6(1): e12056.
8.	Ismail Z, Black SE, Camicioli R, et al. Recommendations of the 5th Canadian consensus conference on the diagnosis and treatment of dementia. Alzheimers Dement, 2020, 16(8): 1182-1195.
9.	王水平, 陶珍, 丁素菊, 等. 高壓氧并鹽酸多奈哌齊治療血管性癡呆的療效觀察. 中華物理醫學與康復雜志, 2009, 31(7): 478-480.
10.	荊宏建, 羅松平, 張津華. 高壓氧聯合多奈哌齊治療血管性癡呆伴失語的觀察. 實用老年醫學, 2009, 23(6): 475-476.
11.	吳泳, 梁雁, 黃丹丹. 奧拉西坦聯合高壓氧治療血管性癡呆療效觀察. 中國實用神經疾病雜志, 2010, 13(7): 13-14.
12.	陳士東. 奧拉西坦與高壓氧聯合治療血管性癡呆 41 例療效觀察. 醫學理論與實踐, 2011, 24(12): 1425-1426.
13.	王松林, 翟魯輝. 高壓氧與奧拉西坦聯合治療血管性癡呆 40 例療效觀察. 中國醫藥指南, 2011, 9(32): 312-313.
14.	鄧曉玲, 汪健, 趙斌. 高壓氧對血管性癡呆患者認知和生活能力及血液流變學的影響. 中國康復, 2011, 26(2): 96-97.
15.	卜桂文. 聯合應用奧拉西坦與高壓氧對 96 例血管性癡呆病人的臨床療效觀察. 心理醫生(下半月版), 2012(10): 80.
16.	梁花敏, 范學文. 高壓氧聯合鹽酸多奈哌齊干預輕度血管性認知障礙療效觀察. 寧夏醫科大學學報, 2012, 34(3): 276-278.
17.	祁文君, 張義, 羅亨勤, 等. 奧拉西坦聯合高壓氧治療輕度血管性認知障礙的療效觀察. 西南國防醫藥, 2012, 22(12): 1350-1352.
18.	宋玉華. 奧拉西坦與高壓氧聯合治療血管性癡呆 63 例療效觀察. 大家健康(學術版), 2012(6): 5-7.
19.	夏希愿. 高壓氧治療血管性癡呆的療效觀察. 亞太傳統醫藥, 2012, 8(1): 84-85.
20.	姜薇薇, 陳藝敏. 高壓氧聯合奧拉西坦治療血管性認知功能障礙的療效觀察. 中國醫學工程, 2013, 21(12): 131.
21.	李文. 高壓氧聯合奧拉西坦治療血管性癡呆 36 例療效分析. 中國醫藥科學, 2013, 3(4): 63-64.
22.	唐龍沖, 鄭湛云, 李新鴻, 等. 高壓氧對血管性癡呆患者認知的影響研究. 中國醫藥指南, 2013(13): 92.
23.	劉麗, 高焱. 奧拉西坦聯合高壓氧治療血管性癡呆療效觀察. 中國民康醫學, 2015(2): 80-81.
24.	孫薇, 楊建波, 徐金鳳, 等. 丁苯酞軟膠囊聯合高壓氧治療老年血管性癡呆的臨床療效觀察. 實用心腦肺血管病雜志, 2015, 23(9): 62-64.
25.	許玫. 分析奧拉西坦與高壓氧在血管性癡呆治療中的應用. 中國繼續醫學教育, 2015(30): 190-191.
26.	趙鵬翔. 丁苯酞軟膠囊聯合高壓氧治療血管性癡呆療效觀察. 基層醫學論壇, 2015(5): 610-611.
27.	柳志一. 奧拉西坦與高壓氧聯合治療血管性癡呆的臨床效果分析. 中國醫療器械信息, 2016, 22(18): 87-88.
28.	喬宇. 奧拉西坦聯合高壓氧治療血管性癡呆患者的臨床療效. 中國藥物經濟學, 2016, 11(6): 46-48.
29.	沈雷. 高壓氧聯合鹽酸多奈哌齊治療輕中度血管性認知障礙患者的療效觀察. 中國藥物經濟學, 2016, 11(9): 92-93.
30.	吳輝麗, 唐妍妍. 丁苯酞聯合高壓氧治療血管性癡呆療效分析. 現代醫藥衛生, 2016, 32(23): 3696-3697.
31.	趙靜華. 丁苯酞聯合高壓氧治療血管性認知功能障礙患者的療效觀察. 心理醫生, 2016, 22(11): 26-28.
32.	周莎莎. 鹽酸多奈哌齊聯合高壓氧治療腦卒中后血管性認知障礙的效果觀察. 中國實用神經疾病雜志, 2016, 19(19): 63-64.
33.	李培忠. 高壓氧聯合鹽酸多奈哌齊干預輕度血管性認知障礙的效果觀察. 臨床合理用藥雜志, 2017, 10(5): 27-28.
34.	薛標強. 丁苯酞聯合高壓氧治療老年血管性癡呆的臨床效果觀察. 中國處方藥, 2017, 15(10): 66-67.
35.	周愛華. 血管性癡呆應用奧拉西坦與高壓氧聯合治療的效果研究. 世界臨床醫學, 2017, 11(1): 53,55.
36.	陳金華. 奧拉西坦與高壓氧治療血管性癡呆臨床探討. 中國衛生標準管理, 2018, 9(17): 71-72.
37.	姜廣亞, 婁季宇, 楊霄鵬, 等. 鹽酸多奈哌齊聯合高壓氧治療血管性認知障礙療效觀察. 中國實用神經疾病雜志, 2019, 22(22): 2498-2503.
38.	李紫丞. 高壓氧聯合鹽酸多奈哌齊及美金剛治療老年血管性癡呆患者的療效分析. 首都食品與醫藥, 2020, 27(8): 53.
39.	馮子凌, 劉秀紅, 郭明霞. 丁苯酞軟膠囊聯合高壓氧治療早期血管性認知障礙的療效觀察. 中國實用醫刊, 2021, 48(19): 73-75.
40.	郭留芹, 趙曉玲, 危保松. 高壓氧聯合多奈哌齊和鹽酸美金剛治療血管性認知障礙的效果觀察. 中國實用醫刊, 2021, 48(21): 59-62.
41.	蔣芳況, 王楊, 王麗, 等. 高壓氧聯合有氧運動治療老年輕度血管性癡呆的療效觀察. 國際老年醫學雜志, 2021, 42(5): 275-278.
42.	劉星. 高壓氧+鹽酸多奈哌齊干預輕度血管性認知障礙的臨床效果. 中國現代藥物應用, 2021, 15(14): 163-165.
43.	荀警杰. 高壓氧+鹽酸多奈哌齊聯用治療輕度血管性認知障礙的臨床效果. 中國實用醫藥, 2021, 16(30): 62-64.
44.	張蕊. 奧拉西坦與高壓氧聯合治療血管性癡呆的應用與效果評析. 中國現代藥物應用, 2021, 15(1): 92-94.
45.	Li X, Li J, Yang X, et al. Hyperbaric-oxygen therapy improves survival and functional outcome of acute severe intracerebral hemorrhage. Arch Med Res, 2017, 48(7): 638-652.
46.	Al-Waili NS, Butler GJ, Beale J, et al. Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease. Adv Ther, 2005, 22(6): 659-678.
47.	Rockswold SB, Rockswold GL, Vargo JM, et al. Effects of hyperbaric oxygenation therapy on cerebral metabolism and intracranial pressure in severely brain injured patients. J Neurosurg, 2001, 94(3): 403-411.
48.	Zhou Y, Dong Q, Pan Z, et al. Hyperbaric oxygen improves functional recovery of the injured spinal cord by inhibiting inflammation and glial scar formation. Am J Phys Med Rehabil, 2019, 98(10): 914-920.
49.	Huang X, Liang P, Jiang B, et al. Hyperbaric oxygen potentiates diabetic wound healing by promoting fibroblast cell proliferation and endothelial cell angiogenesis. Life Sci, 2020, 259: 118246.
50.	Yang Y, Wei H, Zhou X, et al. Hyperbaric oxygen promotes neural stem cell proliferation by activating vascular endothelial growth factor/extracellular signal-regulated kinase signaling after traumatic brain injury. Neuroreport, 2017, 28(18): 1232-1238.
51.	Hedetoft M, Polzik P, Olsen NV, et al. Neuronal nitric oxide inhibition attenuates the protective effect of HBO2 during cyanide poisoning. Undersea Hyperb Med, 2018, 45(3): 335-350.
52.	Thompson LW, Davis GC, Obrist WD, et al. Effects of hyperbaric oxygen on behavioral and physiological measures in elderly demented patients. J Gerontol, 1976, 31(1): 23-28.
53.	程媛媛, 張云東. 高壓氧治療血管性癡呆隨機對照試驗的 Meta 分析. 中國當代醫藥, 2016, 23(29): 16-19.

1. 中國醫師協會神經內科分會認知障礙專業委員會, 《中國血管性認知障礙診治指南》編寫組. 2019 年中國血管性認知障礙診治指南. 中華醫學雜志, 2019, 99(35): 2737-2744.
2. O’Brien JT, Wiseman R, Burton EJ, et al. Cognitive associations of subcortical white matter lesions in older people. Ann N Y Acad Sci, 2002, 977: 436-444.
3. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2011, 42(9): 2672-2713.
4. Skrobot OA, Black SE, Chen C, et al. Progress toward standardized diagnosis of vascular cognitive impairment: guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimers Dement, 2018, 14(3): 280-292.
5. Shah H, Albanese E, Duggan C, et al. Research priorities to reduce the global burden of dementia by 2025. Lancet Neurol, 2016, 15(12): 1285-1294.
6. Larsson SC, Markus HS. Does treating vascular risk factors prevent dementia and Alzheimer’s disease? A systematic review and meta-analysis. J Alzheimers Dis, 2018, 64(2): 657-668.
7. Smith EE, Barber P, Field TS, et al. Canadian consensus conference on diagnosis and treatment of dementia (CCCDTD)5: guidelines for management of vascular cognitive impairment. Alzheimers Dement (N Y), 2020, 6(1): e12056.
8. Ismail Z, Black SE, Camicioli R, et al. Recommendations of the 5th Canadian consensus conference on the diagnosis and treatment of dementia. Alzheimers Dement, 2020, 16(8): 1182-1195.
9. 王水平, 陶珍, 丁素菊, 等. 高壓氧并鹽酸多奈哌齊治療血管性癡呆的療效觀察. 中華物理醫學與康復雜志, 2009, 31(7): 478-480.
10. 荊宏建, 羅松平, 張津華. 高壓氧聯合多奈哌齊治療血管性癡呆伴失語的觀察. 實用老年醫學, 2009, 23(6): 475-476.
11. 吳泳, 梁雁, 黃丹丹. 奧拉西坦聯合高壓氧治療血管性癡呆療效觀察. 中國實用神經疾病雜志, 2010, 13(7): 13-14.
12. 陳士東. 奧拉西坦與高壓氧聯合治療血管性癡呆 41 例療效觀察. 醫學理論與實踐, 2011, 24(12): 1425-1426.
13. 王松林, 翟魯輝. 高壓氧與奧拉西坦聯合治療血管性癡呆 40 例療效觀察. 中國醫藥指南, 2011, 9(32): 312-313.
14. 鄧曉玲, 汪健, 趙斌. 高壓氧對血管性癡呆患者認知和生活能力及血液流變學的影響. 中國康復, 2011, 26(2): 96-97.
15. 卜桂文. 聯合應用奧拉西坦與高壓氧對 96 例血管性癡呆病人的臨床療效觀察. 心理醫生(下半月版), 2012(10): 80.
16. 梁花敏, 范學文. 高壓氧聯合鹽酸多奈哌齊干預輕度血管性認知障礙療效觀察. 寧夏醫科大學學報, 2012, 34(3): 276-278.
17. 祁文君, 張義, 羅亨勤, 等. 奧拉西坦聯合高壓氧治療輕度血管性認知障礙的療效觀察. 西南國防醫藥, 2012, 22(12): 1350-1352.
18. 宋玉華. 奧拉西坦與高壓氧聯合治療血管性癡呆 63 例療效觀察. 大家健康(學術版), 2012(6): 5-7.
19. 夏希愿. 高壓氧治療血管性癡呆的療效觀察. 亞太傳統醫藥, 2012, 8(1): 84-85.
20. 姜薇薇, 陳藝敏. 高壓氧聯合奧拉西坦治療血管性認知功能障礙的療效觀察. 中國醫學工程, 2013, 21(12): 131.
21. 李文. 高壓氧聯合奧拉西坦治療血管性癡呆 36 例療效分析. 中國醫藥科學, 2013, 3(4): 63-64.
22. 唐龍沖, 鄭湛云, 李新鴻, 等. 高壓氧對血管性癡呆患者認知的影響研究. 中國醫藥指南, 2013(13): 92.
23. 劉麗, 高焱. 奧拉西坦聯合高壓氧治療血管性癡呆療效觀察. 中國民康醫學, 2015(2): 80-81.
24. 孫薇, 楊建波, 徐金鳳, 等. 丁苯酞軟膠囊聯合高壓氧治療老年血管性癡呆的臨床療效觀察. 實用心腦肺血管病雜志, 2015, 23(9): 62-64.
25. 許玫. 分析奧拉西坦與高壓氧在血管性癡呆治療中的應用. 中國繼續醫學教育, 2015(30): 190-191.
26. 趙鵬翔. 丁苯酞軟膠囊聯合高壓氧治療血管性癡呆療效觀察. 基層醫學論壇, 2015(5): 610-611.
27. 柳志一. 奧拉西坦與高壓氧聯合治療血管性癡呆的臨床效果分析. 中國醫療器械信息, 2016, 22(18): 87-88.
28. 喬宇. 奧拉西坦聯合高壓氧治療血管性癡呆患者的臨床療效. 中國藥物經濟學, 2016, 11(6): 46-48.
29. 沈雷. 高壓氧聯合鹽酸多奈哌齊治療輕中度血管性認知障礙患者的療效觀察. 中國藥物經濟學, 2016, 11(9): 92-93.
30. 吳輝麗, 唐妍妍. 丁苯酞聯合高壓氧治療血管性癡呆療效分析. 現代醫藥衛生, 2016, 32(23): 3696-3697.
31. 趙靜華. 丁苯酞聯合高壓氧治療血管性認知功能障礙患者的療效觀察. 心理醫生, 2016, 22(11): 26-28.
32. 周莎莎. 鹽酸多奈哌齊聯合高壓氧治療腦卒中后血管性認知障礙的效果觀察. 中國實用神經疾病雜志, 2016, 19(19): 63-64.
33. 李培忠. 高壓氧聯合鹽酸多奈哌齊干預輕度血管性認知障礙的效果觀察. 臨床合理用藥雜志, 2017, 10(5): 27-28.
34. 薛標強. 丁苯酞聯合高壓氧治療老年血管性癡呆的臨床效果觀察. 中國處方藥, 2017, 15(10): 66-67.
35. 周愛華. 血管性癡呆應用奧拉西坦與高壓氧聯合治療的效果研究. 世界臨床醫學, 2017, 11(1): 53,55.
36. 陳金華. 奧拉西坦與高壓氧治療血管性癡呆臨床探討. 中國衛生標準管理, 2018, 9(17): 71-72.
37. 姜廣亞, 婁季宇, 楊霄鵬, 等. 鹽酸多奈哌齊聯合高壓氧治療血管性認知障礙療效觀察. 中國實用神經疾病雜志, 2019, 22(22): 2498-2503.
38. 李紫丞. 高壓氧聯合鹽酸多奈哌齊及美金剛治療老年血管性癡呆患者的療效分析. 首都食品與醫藥, 2020, 27(8): 53.
39. 馮子凌, 劉秀紅, 郭明霞. 丁苯酞軟膠囊聯合高壓氧治療早期血管性認知障礙的療效觀察. 中國實用醫刊, 2021, 48(19): 73-75.
40. 郭留芹, 趙曉玲, 危保松. 高壓氧聯合多奈哌齊和鹽酸美金剛治療血管性認知障礙的效果觀察. 中國實用醫刊, 2021, 48(21): 59-62.
41. 蔣芳況, 王楊, 王麗, 等. 高壓氧聯合有氧運動治療老年輕度血管性癡呆的療效觀察. 國際老年醫學雜志, 2021, 42(5): 275-278.
42. 劉星. 高壓氧+鹽酸多奈哌齊干預輕度血管性認知障礙的臨床效果. 中國現代藥物應用, 2021, 15(14): 163-165.
43. 荀警杰. 高壓氧+鹽酸多奈哌齊聯用治療輕度血管性認知障礙的臨床效果. 中國實用醫藥, 2021, 16(30): 62-64.
44. 張蕊. 奧拉西坦與高壓氧聯合治療血管性癡呆的應用與效果評析. 中國現代藥物應用, 2021, 15(1): 92-94.
45. Li X, Li J, Yang X, et al. Hyperbaric-oxygen therapy improves survival and functional outcome of acute severe intracerebral hemorrhage. Arch Med Res, 2017, 48(7): 638-652.
46. Al-Waili NS, Butler GJ, Beale J, et al. Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease. Adv Ther, 2005, 22(6): 659-678.
47. Rockswold SB, Rockswold GL, Vargo JM, et al. Effects of hyperbaric oxygenation therapy on cerebral metabolism and intracranial pressure in severely brain injured patients. J Neurosurg, 2001, 94(3): 403-411.
48. Zhou Y, Dong Q, Pan Z, et al. Hyperbaric oxygen improves functional recovery of the injured spinal cord by inhibiting inflammation and glial scar formation. Am J Phys Med Rehabil, 2019, 98(10): 914-920.
49. Huang X, Liang P, Jiang B, et al. Hyperbaric oxygen potentiates diabetic wound healing by promoting fibroblast cell proliferation and endothelial cell angiogenesis. Life Sci, 2020, 259: 118246.
50. Yang Y, Wei H, Zhou X, et al. Hyperbaric oxygen promotes neural stem cell proliferation by activating vascular endothelial growth factor/extracellular signal-regulated kinase signaling after traumatic brain injury. Neuroreport, 2017, 28(18): 1232-1238.
51. Hedetoft M, Polzik P, Olsen NV, et al. Neuronal nitric oxide inhibition attenuates the protective effect of HBO2 during cyanide poisoning. Undersea Hyperb Med, 2018, 45(3): 335-350.
52. Thompson LW, Davis GC, Obrist WD, et al. Effects of hyperbaric oxygen on behavioral and physiological measures in elderly demented patients. J Gerontol, 1976, 31(1): 23-28.
53. 程媛媛, 張云東. 高壓氧治療血管性癡呆隨機對照試驗的 Meta 分析. 中國當代醫藥, 2016, 23(29): 16-19.

West China Medical Journal

Efficacy and safety of hyperbaric oxygen therapy for vascular cognitive impairment: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content