Shan Chun-Shuo, Zhang Hong-Feng, Xu Qing-Qing, Shi Yi-Hua, Wang Yong, Li Yan, Lin Yan, Zheng Guo-Qing
Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Aging Neurosci. 2018 Nov 8;10:349. doi: 10.3389/fnagi.2018.00349. eCollection 2018.
Parkinson's disease (PD) is a debitlitating, chronic, progressive neurodegenerative disorder without modifying therapy. Here, we aimed to evaluate the available evidence of herbal medicine (HM) formulas for patients with PD according to randomized double-blind placebo-controlled clinical trials. HM formulas for PD were searched in eight main databases from their inception to February 2018. The methodological quality was assessed using Cochrane Collaboration risk of bias tool. Meta-analysis was performed using RevMan 5.3 software. Fourteen trials with Seventeen comparisons comprising 1,311 patients were identified. Compared with placebo groups, HM paratherapy ( = 16 comparisons) showed significant better effects in the assessments of total Unified Parkinson's Disease Rating Scale (UPDRS) (WMD: -5.43, 95% CI:-8.01 to -2.86; < 0.0001), UPDRS I (WMD: -0.30, 95% CI: -0.54 to -0.06; = 0.02), UPDRS II (WMD: -2.21, 95% CI: -3.19 to -1.22; < 0.0001), UPDRS III (WMD: -3.26, 95% CI:-4.36 to -2.16; < 0.00001), Parkinson's Disease Quality of Life Questionnaire ( < 0.01) and Parkinson's Disease Questionnaire-39 (WMD: -7.65, 95% CI: -11.46 to -3.83; < 0.0001), Non-motor Symptoms Questionnaire ( < 0.01) and Non-Motor Symptoms Scale (WMD: -9.19, 95% CI: -13.11 to -5.28; < 0.00001), Parkinson's Disease Sleep Scale (WMD: 10.69, 95% CI: 8.86 to 12.53; < 0.00001), and Hamilton depression rating scale (WMD: -5.87, 95% CI: -7.06 to -4.68; < 0.00001). The efficiency of HM monotherapy ( = 1 comparison) was not superior to the placebo according to UPDRS II, UPDRS III and total UPDRS score in PD patients who never received levodopa treatment, all > 0.05. HM formulas paratherapy were generally safe and well tolerated for PD patients (RR: 0.41, 95% CI: 0.21 to 0.80; = 0.009). The findings of present study supported the complementary use of HM paratherapy for PD patients, whereas the question on the efficacy of HM monotherapy in alleviating PD symptoms is still open.
帕金森病（PD）是一种致残性的慢性进行性神经退行性疾病，目前尚无特效治疗方法。在此，我们旨在根据随机双盲安慰剂对照临床试验，评估用于帕金森病患者的草药配方（HM）的现有证据。从各主要数据库建库至2018年2月，检索了用于帕金森病的草药配方。使用Cochrane协作网偏倚风险工具评估方法学质量。使用RevMan 5.3软件进行荟萃分析。共纳入14项试验，17组比较，涉及1311例患者。与安慰剂组相比，草药辅助治疗（n = 16组比较）在统一帕金森病评定量表（UPDRS）总分（加权均数差：-5.43，95%可信区间：-8.01至-2.86；P < 0.0001）、UPDRS I（加权均数差：-0.30，95%可信区间：-0.54至-0.06；P = 0.02）、UPDRS II（加权均数差：-2.21，95%可信区间：-3.19至-1.22；P < 0.0001）、UPDRS III（加权均数差：-3.26，95%可信区间：-4.36至-2.16；P < 0.00001）、帕金森病生活质量问卷（P < 0.01）、帕金森病问卷-39（加权均数差：-7.65，95%可信区间：-11.46至-3.83；P < 0.0001）、非运动症状问卷（P < 0.01）和非运动症状量表（加权均数差：-9.19，95%可信区间：-13.11至-5.28；P < 0.00001）、帕金森病睡眠量表（加权均数差：10.69，95%可信区间：8.86至12.53；P < 0.00001）以及汉密尔顿抑郁评定量表（加权均数差：-5.87，95%可信区间：-7.06至-4.68；P < 0.00001）的评估中显示出显著更好的效果。在从未接受过左旋多巴治疗的帕金森病患者中，根据UPDRS II、UPDRS III和UPDRS总分，草药单一疗法（n = 1组比较）的疗效并不优于安慰剂，所有P > 0.05。草药配方辅助治疗对帕金森病患者总体安全且耐受性良好（相对危险度：0.41，95%可信区间：0.21至0.80；P = 0.009）。本研究结果支持草药辅助治疗可用于帕金森病患者，但草药单一疗法缓解帕金森病症状的疗效问题仍未明确。
