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针灸治疗帕金森病患者神经精神症状的疗效和安全性:系统评价和荟萃分析。

Efficacy and safety of acupuncture therapy for neuropsychiatric symptoms among patients with Parkinson's disease: A systematic review and meta-analysis.

机构信息

Graduate College, Guangxi University of Chinese Medicine, Nanning, China.

Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Clin Rehabil. 2024 Aug;38(8):1044-1062. doi: 10.1177/02692155241258278. Epub 2024 Jun 5.

Abstract

OBJECTIVE

To systematically evaluate the efficacy and safety of acupuncture therapy for neuropsychiatric symptoms in patients with Parkinson's disease.

METHODS

We searched eight databases from their inception until 14 April 2024, including PubMed, Cochrane Library, Embase, Web of Science, SinoMed, China National Knowledge Infrastructure, China Science and Technology Periodical Database, and Wanfang Database. The search aimed to find randomized controlled trials assessing the effectiveness of acupuncture for neuropsychiatric symptoms in patients with Parkinson's disease. Literature screening and data extraction were performed independently by the authors. Meta-analysis was conducted using RevMan V.5.3 software, and Stata 17.0 software was used for detecting publication bias and performing sensitivity analysis.

RESULTS

Twenty-eight studies, involving 2148 participants, met the inclusion criteria. The meta-analysis revealed that acupuncture therapy improved depression-related scale scores (standardized mean difference (SMD) = -0.70, 95%CI [-0.98, -0.42], < 0.00001), anxiety-related scale scores (SMD = -0.78, 95% CI [-1.43, -0.14], = 0.02), Montreal Cognitive Assessment scores (weighted mean difference (WMD) = 2.74, 95% CI [2.43, 3.05], < 0.00001), Mini Mental State Examination scores (WMD = 2.36, 95% CI [0.78, 3.94], = 0.003), Yale-Brown Obsessive Compulsive Scale scores, and Parkinson's Disease Questionnaire-39 scores (WMD = -2.66, 95% CI [-4.83, -0.49], = 0.02) compared to controls.

CONCLUSION

This review supports the application of acupuncture to reduce the severity of neuropsychiatric symptoms including depression, anxiety, and impulse control disorders, and to improve cognition and quality of life in patients with Parkinson's disease. The adverse effects associated with acupuncture, either alone or as adjunctive therapy, were relatively minor.

摘要

目的

系统评价针灸治疗帕金森病患者神经精神症状的疗效和安全性。

方法

我们检索了 8 个数据库,从建库到 2024 年 4 月 14 日,包括 PubMed、Cochrane 图书馆、Embase、Web of Science、SinoMed、中国知网、中国科技期刊数据库和万方数据库。搜索旨在寻找评估针灸治疗帕金森病患者神经精神症状疗效的随机对照试验。作者独立进行文献筛选和数据提取。使用 RevMan V.5.3 软件进行荟萃分析,使用 Stata 17.0 软件检测发表偏倚并进行敏感性分析。

结果

28 项研究,涉及 2148 名参与者,符合纳入标准。荟萃分析显示,针灸治疗可改善抑郁相关量表评分(标准化均数差(SMD)=-0.70,95%CI[-0.98,-0.42],<0.00001)、焦虑相关量表评分(SMD=-0.78,95%CI[-1.43,-0.14],=0.02)、蒙特利尔认知评估量表评分(加权均数差(WMD)=2.74,95%CI[2.43,3.05],<0.00001)、简易精神状态检查量表评分(WMD=2.36,95%CI[0.78,3.94],=0.003)、耶鲁-布朗强迫量表评分和帕金森病问卷-39 评分(WMD=-2.66,95%CI[-4.83,-0.49],=0.02),与对照组相比。

结论

本综述支持应用针灸疗法减轻帕金森病患者神经精神症状的严重程度,包括抑郁、焦虑和冲动控制障碍,并改善认知和生活质量。针灸单独或作为辅助治疗的不良反应相对较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a9b/11348633/38df208e7991/10.1177_02692155241258278-fig1.jpg

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