Abstract
Background
Acupuncture seems to improve cognitive function in experimental models and to reduce agitation in dementia. The addition of acupuncture to standard-of-care (SOC) may improve clinical outcomes related to delirium in hospitalized older adults.
Methods
This pragmatic open-label randomized-controlled trial evaluated 81 older adults hospitalized in an internal medicine ward and diagnosed with delirium. Fifty were randomized to daily acupuncture combined with SOC and 31 to SOC only for up to 1 week. Delirium was diagnosed using Confusion Assessment Method (CAM) tool, and its severity was assessed by the long CAM-Severity (CAM-S) tool. The primary study outcome was delirium resolution evaluated as time-to-first delirium remission (over 7 days) and the number of days spent delirium-free.
Results
Time-to-first delirium remission was shorter in the acupuncture arm as compared to the SOC only arm (p < 0.001). A multivariate Cox regression analysis showed a shorter time-to-first remission of delirium in the acupuncture arm as compared with SOC arm [Hazard Ratio 0.267 (95% CI 0.098-0.726, p = 0.010)]. In the 7 days of evaluation, a significantly higher number of delirium-free days was found in the acupuncture arm compared to the SOC arm (p < 0.001), and CAM-S sum from day 2 to day 7 of evaluation was significantly lower in the acupuncture group compared to the control group (p = 0.002). No adverse safety event was found in the acupuncture group.
Conclusion
Acupuncture seems to be safe and effective in the treatment of delirium in older patients hospitalized in internal medicine departments.
Autoren
Ilana Levy, Sagi Gavrieli, Talia Hefer, Samuel Attias, Ariel Schiff, Ron Oliven, Shikma Wisberg-Levi, Rina Hanchinsky, Elad Schiff
Journal
J Geriatr Psychiatry Neurol. 2022 May;35(3):333-343. doi: 10.1177/0891988721996804. Epub 2021 Mar 9.
Link: https://journals.sagepub.com/doi/10.1177/0891988721996804
Kommentar:
Protokolle je nach Delir-Typ und TCM-Diagnose.
Hyperaktives Delir:
Leber-Feuer: Mikroaderlass an PC 9, He 9 oder PC 8; He 8, MP 10, MP 6, Di 11, Ma 44, Du 24,
Ohr Shenmen
Schleim-Feuer: Ma 40, MP 10, Le 2, PC 8 – PC 5, Ohr Shenmen
Hypoaktives Delir:
Qi & Yang Mangel: Element-im-Element Punkte, Ma 36 oder Ma 40; MP 6, Ren 6, PC 7, PC 6, Ren 20,
Yin tang, Ni 7
Yang-Mangel mit Schleim: Ma 40, Ma 36, Ni 7, PC 5, PC 7, Ren 6, Du 20, Du 24, Yin tang
Mischform:
Blut und Qi Mangel: PC 6, PC 7, He 7, MP 4, MP 6
Yin-Mangel: He 8, He 6, PC 8, MP 10, MP 6, Ni 6, Ni 1