Table 2_Herbal medicine and acupuncture for mild cognitive impairment: a retrospective study of 2,242 for older adults in Republic of Korea.docx

IntroductionDementia prevalence increases with age, underscoring the importance of early intervention for mild cognitive impairment (MCI). However, standard treatment recommendations for MCI remain lacking. Herbal medicine and acupuncture have been proposed as potential alternatives. This study evaluated the feasibility and effectiveness of these interventions in patients with MCI.
MethodsWe conducted a retrospective cohort study using data from a public health promotion program for community-dwelling older adults in Korea who received acupuncture, with or without herbal medicine, between 2021 and 2023. Feasibility was assessed by completion of acupuncture sessions and follow-up. Exact propensity score matching was performed using age, sex, comorbidities, depression scores, and health-related behaviors to compare herbal medicine add-on versus acupuncture only groups. Clinical outcomes included cognitive function [the Cognitive Impairment Screening Test (CIST) and the Montreal Cognitive Assessment (MoCA)] and depression [Geriatric Depression Scale–Short Form (GDS-SF)].
ResultsOf 5,525 participants, 4,623 received acupuncture with or without herbal medicine. Feasibility was high, with 86.4% completing planned acupuncture sessions; among these, 93.8% also received herbal medicine. Loss-to-follow-up rate was lower in the herbal medicine add-on (4.1%) than in the acupuncture-only (12.1%). After matching, 2,242 participants were included (2,044 herbal medicine add-on and 198 acupuncture-only). Both groups showed significant improvements in CIST, MoCA, and GDS-SF scores, with the herbal medicine add-on group demonstrating significantly greater cognitive improvement in the CIST (coefficient: 0.58; 95% CI, 0.10–1.08).
ConclusionHerbal medicine combined with acupuncture appeared feasible and potentially effective for managing MCI, supporting its practicality in community settings. However, its therapeutic benefits need to be further validated through rigorously designed randomized controlled trials. Long-term studies are warranted to confirm these findings and clarify their role in dementia prevention.

引言 痴呆患病率随年龄增长而升高，凸显了轻度认知障碍（mild cognitive impairment, MCI）早期干预的重要性。然而，目前针对轻度认知障碍的标准治疗方案仍有所欠缺。中医药与针灸已被提出作为潜在的替代治疗手段。本研究评估了上述干预手段用于轻度认知障碍患者的可行性与有效性。
方法 本研究针对2021年至2023年间，韩国社区居住老年人群体公共健康促进项目中接受针灸联合或不联合中药治疗的队列数据开展回顾性队列研究。可行性通过针灸疗程完成情况与随访完成情况进行评估。基于年龄、性别、合并症、抑郁评分及健康相关行为进行精确倾向得分匹配，以对比中药联合治疗组与单纯针灸治疗组的疗效差异。临床结局指标包括认知功能[认知障碍筛查试验（Cognitive Impairment Screening Test, CIST）与蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）]及抑郁状况[老年抑郁量表简版（Geriatric Depression Scale–Short Form, GDS-SF）]。
结果 本研究共纳入5525名参与者，其中4623名接受了针灸联合或不联合中药治疗。整体可行性较高，86.4%的参与者完成了计划内的针灸疗程；其中93.8%同时接受了中药治疗。中药联合治疗组的失访率（4.1%）低于单纯针灸治疗组（12.1%）。倾向得分匹配后，共纳入2242名参与者（中药联合治疗组2044名，单纯针灸治疗组198名）。两组受试者的CIST、MoCA及GDS-SF评分均出现显著改善，其中中药联合治疗组在CIST评分上的认知改善效果更为显著（系数：0.58；95%置信区间：0.10–1.08）。
结论 针灸联合中药治疗用于轻度认知障碍管理时，具备可行性且潜在疗效显著，为其在社区医疗场景中的应用提供了实践依据。但该疗法的治疗获益仍需通过设计严谨的随机对照试验进一步验证。未来需开展长期随访研究以确认本研究结果，并明确其在痴呆预防中的作用。