Traditional Chinese Medicine College, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Acupuncture College, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Medicine (Baltimore). 2023 Jul 28;102(30):e34425. doi: 10.1097/MD.0000000000034425.
Parkinson disease (PD) is the second most common neurodegenerative disease, which has impacts on the patient's quality of life due to non-motor symptoms such as sleep disorders, anxiety, and depression. Traditional Chinese medicine (TCM) has gained increasing attention in the diagnosis and treatment of PD with the concept of "overall concepts and dialectical treatment." Therefore, exploring the characteristics of TCM in the treatment of PD can improve the level of diagnosis and treatment of PD.
A comprehensive literature search was conducted using the following electronic databases: PubMed, Web of Science, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure. The inclusion criteria were randomized controlled trials (RCTs) that compared TCM intervention with conventional treatments or placebo for non-motor symptoms in PD. The quality of the included RCTs was assessed using the Cochrane risk of bias tool.
A total of 9 RCTs involving 1714 participants with PD were included in this systematic review and meta-analysis. The meta-analysis showed that TCM was effective in improving non-motor symptoms, including depression (Hamilton depression rating scale [HAMD], weighted mean difference [WMD] = 4.24, 95% CI = 2.84-5.65, P < .0001), anxiety (HAMA, WMD = 4.03, 95% CI = 2.64-5.41, P < .0001), autonomic dysfunction (Scales for Outcomes in Parkinson's disease-Autonomic, WMD = 4.57, 95% CI = 1.69-7.45, P = .002), non-motor symptoms (Movement Disorder Society-Unified Parkinson's Disease Rating Scale-part 1, WMD = 0.66, 95% CI = 0.20-1011, P = .004), and quality of life (PDQ-39, WMD = 6.72, 95% CI = 0.87-12.58, P < .05), compared with baseline. Zishen Pingchan granules was particularly effective for depression (HAMD, WMD = -1.94, 95% CI = -3.07 to -0.81, P < .001, compared to placebo; HAMD, WMD = 3.40, 95% CI = 0.52-6.28, P < .05, after treatment). Pingchan granules was particularly effective for quality of life after treatment (PDQ-39, WMD = 10.20, 95% CI = 1.87-18.53, P < .05).
TCM is effective and safety for improvement of depression, anxiety, autonomic dysfunctions, and quality of life in PD. Zishen Pingchan granules was particularly effective for depression; and Pingchan granules was particularly effective for quality of life.
帕金森病（PD）是第二常见的神经退行性疾病，由于非运动症状如睡眠障碍、焦虑和抑郁，会对患者的生活质量产生影响。中医（TCM）以“整体观念和辩证治疗”的理念，在 PD 的诊断和治疗中受到越来越多的关注。因此，探索 TCM 在 PD 治疗中的特点可以提高 PD 的诊断和治疗水平。
使用以下电子数据库全面检索文献：PubMed、Web of Science、Embase、Scopus、Cochrane Library 和中国国家知识基础设施。纳入标准为比较 TCM 干预与常规治疗或安慰剂对 PD 非运动症状的随机对照试验（RCT）。使用 Cochrane 偏倚风险工具评估纳入 RCT 的质量。
本系统评价和荟萃分析共纳入 9 项 RCT，涉及 1714 名 PD 患者。荟萃分析显示，TCM 改善非运动症状有效，包括抑郁（汉密尔顿抑郁评定量表[HAMD]，加权均数差[WMD] = 4.24，95%CI = 2.84-5.65，P <.0001）、焦虑（汉密尔顿焦虑量表[HAMA]，WMD = 4.03，95%CI = 2.64-5.41，P <.0001）、自主神经功能障碍（帕金森病结局量表-自主神经，WMD = 4.57，95%CI = 1.69-7.45，P =.002）、非运动症状（运动障碍学会统一帕金森病评定量表-第 1 部分，WMD = 0.66，95%CI = 0.20-1011，P =.004）和生活质量（帕金森病生活质量问卷[PDQ-39]，WMD = 6.72，95%CI = 0.87-12.58，P <.05），与基线相比。与安慰剂相比，Zishen Pingchan 颗粒对抑郁（HAMD，WMD = -1.94，95%CI = -3.07 至-0.81，P <.001）特别有效；与安慰剂相比，Zishen Pingchan 颗粒对生活质量（PDQ-39，WMD = 10.20，95%CI = 1.87-18.53，P <.05）特别有效。
TCM 对改善 PD 的抑郁、焦虑、自主神经功能障碍和生活质量是有效和安全的。Zishen Pingchan 颗粒对抑郁特别有效；而 Pingchan 颗粒对生活质量特别有效。
