Zhang Guoxin, Xiong Nian, Zhang Zhentao, Liu Ling, Huang Jinsha, Yang Jiaolong, Wu Jing, Lin Zhicheng, Wang Tao
Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
PLoS One. 2015 Mar 10;10(3):e0118498. doi: 10.1371/journal.pone.0118498. eCollection 2015.
Idiopathic Parkinson disease (PD) is a common neurodegenerative disease that seriously hinders limb activities and affects patients' lives. We performed a meta-analysis aiming to systematically review and quantitatively synthesize the efficacy and safety of traditional Chinese medicine (TCM) as an adjunct therapy for clinical PD patients.
An electronic search was conducted in PubMed, Cochrane Controlled Trials Register, China National Knowledge Infrastructure, Chinese Scientific Journals Database and Wanfang data to identify randomized trials evaluating TCM adjuvant therapy versus conventional treatment. The change from baseline of the Unified Parkinson's Disease Rating Scale score (UPDRS) was used to estimate the effectiveness of the therapies.
Twenty-seven articles involving 2314 patients from 1999 to 2013 were included. Potentially marked improvements were shown in UPDRS I (SMD 0.68, 95%CI 0.38, 0.98), II (WMD 2.41, 95%CI 1.66, 2.62), III (WMD 2.45, 95%CI 2.03, 2.86), IV (WMD 0.32, 95%CI 0.15, 049) and I-IV total scores (WMD 6.18, 95%CI 5.06, 7.31) in patients with TCM plus dopamine replacement therapy (DRT) compared to DRT alone. Acupuncture add-on therapy was markedly beneficial for improving the UPDRS I-IV total score of PD patients (WMD 10.96, 95%CI 5.85, 16.07). However, TCM monotherapy did not improve the score. The effectiveness seemed to be more obvious in PD patients with longer adjunct durations. TCM adjuvant therapy was generally safe and well tolerated.
Although the data were limited by methodological flaws in many studies, the evidence indicates the potential superiority of TCM as an alternative therapeutic for PD treatment and justifies further high-quality studies.
特发性帕金森病（PD）是一种常见的神经退行性疾病，严重妨碍肢体活动，影响患者生活。我们进行了一项荟萃分析，旨在系统评价和定量合成中药（TCM）作为临床PD患者辅助治疗的疗效和安全性。
在PubMed、Cochrane对照试验注册库、中国知网、中国科技期刊数据库和万方数据中进行电子检索，以识别评估中药辅助治疗与传统治疗的随机试验。采用统一帕金森病评定量表（UPDRS）评分相对于基线的变化来评估治疗效果。
纳入了1999年至2013年涉及2314例患者的27篇文章。与单纯多巴胺替代疗法（DRT）相比，接受中药加DRT治疗的患者在UPDRS I（标准化均数差0.68，95%可信区间0.38，0.98）、II（加权均数差2.41，95%可信区间1.66，2.62）、III（加权均数差2.45，95%可信区间2.03，2.86）、IV（加权均数差0.32，95%可信区间0.15，0.49）以及I-IV总分（加权均数差6.18，95%可信区间5.06，7.31）方面显示出可能显著的改善。针刺辅助治疗对改善PD患者的UPDRS I-IV总分有显著益处（加权均数差10.96，95%可信区间5.85，16.07）。然而，中药单一疗法并未改善评分。在辅助治疗时间较长的PD患者中，疗效似乎更为明显。中药辅助治疗总体安全且耐受性良好。
尽管许多研究的方法学缺陷限制了数据，但证据表明中药作为PD治疗的替代疗法具有潜在优势，值得进一步开展高质量研究。
