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用于特发性帕金森病的中药:随机对照试验的荟萃分析

Chinese medicine for idiopathic Parkinson's disease: A meta analysis of randomized controlled trials.

作者信息

Wei Wei, Chen Hai-Yong, Fan Wen, Ye Shui-Fen, Xu Yi-Hui, Cai Jing

机构信息

College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.

477 Hospital of Chinese People's Liberation Army, Xiangyang, Hubei Province, 441000, China.

出版信息

Chin J Integr Med. 2017 Jan;23(1):55-61. doi: 10.1007/s11655-016-2618-7. Epub 2016 Oct 27.

Abstract

OBJECTIVE

To evaluate the efficacy of Chinese medicine (CM) adjunct to conventional medications for idiopathic Parkinson's disease (PD).

METHODS

Electronic English and Chinese databases including PubMed, Cochrane Library, Web of Science, Chinese Medical Current Contents, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Med Database, and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy. The extracted data was analyzed by the Review Manager 5.0.

RESULTS

Twelve trials involving 869 participants were included in the meta-analysis. Unified PD Rating Scale (UPDRS) I, II, III, IV scores and UPDRS V-IV total scores were used to be the primary outcomes, Parkinson Disease Question-39 (PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes. CM adjunct therapy had greater improvement in UPDRS I [2 trials; standardized mean difference (SMD)-0.40, 95% confidence interval (CI)-0.71 to-0.09; Z=2.49 (P=0.01)], II [5 trials; SMD-0.47, 95% CI-0.69 to-0.25; Z=4.20 (P<0.01)], III [5 trials; SMD-0.35, 95% CI-0.57 to-0.13; Z=3.16 (P=0.002)], IV scores [3 trials; SMD-0.32, 95% CI-0.60 to-0.03; Z=2.17 (P=0.03)], UPDRS I-IV total scores [7 trials; SMD-0.36, 95%CI-0.53 to-0.20; Z=4.24 (P<0.05)]. PDQ-39 and Chinese medical symptoms compared to the conventional medication only.

CONCLUSION

CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.

摘要

目的

评估中药辅助常规药物治疗特发性帕金森病(PD)的疗效。

方法

使用包括PubMed、Cochrane图书馆、科学引文索引、中国生物医学期刊数据库、中国知网、维普中文科技期刊数据库、万方医学数据库和中医数据库系统在内的中英文电子数据库,采用高灵敏度检索策略进行关键词检索。提取的数据采用RevMan 5.0进行分析。

结果

荟萃分析纳入了12项试验,共869名参与者。以统一帕金森病评定量表(UPDRS)I、II、III、IV评分及UPDRS V-IV总分作为主要结局指标,以帕金森病问卷-39(PDQ-39)及中医症状评分作为次要结局指标。与仅使用常规药物相比,中药辅助治疗在UPDRS I[2项试验;标准化均数差(SMD)-0.40,95%置信区间(CI)-0.71至-0.09;Z=2.49(P=0.01)]、II[5项试验;SMD-0.47,95%CI-0.69至-0.25;Z=4.20(P<0.01)]、III[5项试验;SMD-0.35,95%CI-0.57至-0.13;Z=3.16(P=0.002)]、IV评分[3项试验;SMD-0.32,95%CI-0.60至-0.03;Z=2.17(P=0.03)]、UPDRS I-IV总分[7项试验;SMD-0.36,95%CI-0.53至-0.20;Z=4.24(P<0.05)]方面有更大改善。仅将PDQ-39和中医症状与常规药物进行了比较。

结论

中药辅助治疗通过降低UPDRS评分及减少不良反应具有潜在治疗益处。

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