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针刺治疗帕金森病的临床疗效:一项遵循PRISMA的系统评价和Meta分析。

Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review and meta-analysis.

作者信息

Lee Sook-Hyun, Lim Sabina

机构信息

Department of Applied Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University Research Group of Pain and Neuroscience, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute Department of Meridian and Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2017 Jan;96(3):e5836. doi: 10.1097/MD.0000000000005836.

Abstract

BACKGROUND

Parkinson's disease (PD) is the second-most-common chronic and progressive neurodegenerative disease. The long-term use of levodopa leads to a loss of efficacy and to complications. Therefore, many patients with PD have turned to complementary therapies to help relieve their symptoms. Acupuncture is most commonly used as a complementary therapy in patients with PD. This paper presents a systematic review and meta-analysis of the effects of acupuncture for patients with PD. This study was performed to summarize and evaluate evidence regarding the effectiveness of acupuncture in the relief of PD symptoms.

METHODS

Seven databases, namely, MEDLINE, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure [CNKI], and three Korean medical databases, were searched from their inception through August 2015 without language restrictions. Randomized controlled trials (RCTs) were included if they contained reports of acupuncture compared with no treatment and conventional treatment alone or acupuncture plus conventional treatment compared with conventional treatment alone for PD symptoms. Assessments were performed with the unified PD rating scales (UPDRS) I, II, III, and IV and the total score, the Webster scale, and effectiveness rating. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale and the Cochrane risk of bias (ROB).

RESULTS

In all, 982 potentially relevant articles were identified; 25 RCTs met our inclusion criterion, 19 of 25 RCTs were high-quality studies (i.e., a score of 6 or higher). The included RCTs showed favorable results for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS II, III, and IV and the total score. Acupuncture was effective in relieving PD symptoms compared with no treatment and conventional treatment alone, and acupuncture plus conventional treatment had a more significant effect than conventional treatment alone.

CONCLUSIONS

We performed a systematic review and meta-analysis to evaluate the use of acupuncture for relief of PD symptoms and found that acupuncture has significant positive effects. Acupuncture can be considered as a combination treatment with conventional treatment for patients with PD. Further studies on this topic should be carried out according to rigorous methodological designs in both the East and the West.

摘要

背景

帕金森病(PD)是第二常见的慢性进行性神经退行性疾病。长期使用左旋多巴会导致疗效丧失和并发症。因此,许多帕金森病患者转向辅助疗法以帮助缓解症状。针灸是帕金森病患者最常用的辅助疗法。本文对针灸治疗帕金森病患者的效果进行了系统评价和荟萃分析。本研究旨在总结和评估针灸缓解帕金森病症状有效性的证据。

方法

检索了七个数据库,即MEDLINE、EMBASE、Cochrane图书馆、中国知网(CNKI)以及三个韩国医学数据库,检索时间从建库至2015年8月,无语言限制。纳入的随机对照试验(RCT)需包含针刺与不治疗、单纯常规治疗对比的报告,或针刺联合常规治疗与单纯常规治疗对比帕金森病症状的报告。使用统一帕金森病评定量表(UPDRS)I、II、III和IV以及总分、韦伯斯特量表和疗效评定进行评估。使用物理治疗证据数据库(PEDro)量表和Cochrane偏倚风险(ROB)评估方法学质量。

结果

共识别出982篇潜在相关文章;25项RCT符合纳入标准,其中19项为高质量研究(即评分6分及以上)。纳入的RCT显示,与单纯常规治疗相比,针刺联合常规治疗在UPDRS II、III、IV及总分方面有更好的结果。与不治疗和单纯常规治疗相比,针刺在缓解帕金森病症状方面有效,且针刺联合常规治疗比单纯常规治疗效果更显著。

结论

我们进行了系统评价和荟萃分析以评估针刺缓解帕金森病症状的应用,发现针刺有显著的积极作用。针刺可被视为帕金森病患者的联合治疗方法。关于这一主题的进一步研究应在东西方都按照严格的方法学设计进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c7/5279085/af796cf20433/medi-96-e5836-g001.jpg

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