Li Hanzhang, Ju Geyongqin, Chen Jiayi, Wang Yao
Hubei University of Chinese Medicine, Wuhan, PR China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40786. doi: 10.1097/MD.0000000000040786.
Parkinson disease (PD) is a progressive neurological disorder that may be managed with therapies like scalp electroacupuncture (SEA). The combination of SEA and medication could potentially offer a new approach for managing PD symptoms. The systematic review and meta-analysis aimed to assess the combined impact of SEA and medication on PD through a comprehensive analysis of randomized clinical trials, focusing on outcomes like effective rate and various scores (total Unified Parkinson Disease Rating Scale (UPDRS), UPDRS III, and Webster).
It was conducted an unrestricted search from the beginning of each database until April 19, 2024, across 7 databases. These included 4 international databases: PubMed, Web of Science, Scopus, and Cochrane Library, and 3 Chinese databases: CNKI, VIP, and Wanfang. Review Manager, version 5.3 was used to calculate the mean difference (MD) or risk ratio along with a 95% confidence interval (CI). The Comprehensive Meta-Analysis version 3.0 was employed for conducting bias analyses, meta-regression, and sensitivity analyses.
From 1422 records identified in the databases, 17 articles were included in both the systematic review and meta-analysis. The pooled risk ratio and its 95%CI in the intervention (SEA + medication) group compared to the control (medication) group for the effective rate is 1.24 [1.17, 1.32] with a P < .00001. The pooled MD and its 95%CI for the Webster score is -0.51 [-6.36, 5.35] with a P = .86. The pooled MD and its 95%CI for total UPDRS is 8.73 [2.88, 14.58] with a P = .003. The pooled MD and its 95%CI for UPDRS III is 4.42 [3.23, 5.61] with a P < .00001. The results for total UPDRS and UPDRS III showed that intervention reduced the severity and progression of PD in patients more than medication.
The intervention (SEA + medication) has shown significant effectiveness compared to the control (medication) in terms of the effective rate, total UPDRS, and UPDRS III in PD patients. However, it did not show a significant effect on the Webster score.
帕金森病（PD）是一种进行性神经疾病，可通过头皮电针（SEA）等疗法进行管理。SEA与药物联合使用可能为管理PD症状提供一种新方法。本系统评价和荟萃分析旨在通过对随机临床试验的全面分析，评估SEA与药物联合使用对PD的综合影响，重点关注有效率和各种评分（帕金森病统一评分量表（UPDRS）总分、UPDRS III以及韦伯斯特评分）等结果。
于2024年4月19日之前，在7个数据库中进行了无限制检索。这些数据库包括4个国际数据库：PubMed、科学网、Scopus和考克兰图书馆，以及3个中文数据库：中国知网、维普资讯和万方数据。使用Review Manager 5.3版计算平均差（MD）或风险比以及95%置信区间（CI）。采用综合荟萃分析3.0版进行偏倚分析、荟萃回归分析和敏感性分析。
在数据库中识别出的1422条记录中，有17篇文章纳入了系统评价和荟萃分析。与对照组（药物治疗）相比，干预组（SEA + 药物治疗）的有效率合并风险比及其95%CI为1.24 [1.17, 1.32]，P <.00001。韦伯斯特评分的合并MD及其95%CI为 -0.51 [-6.36, 5.35]，P = 0.86。UPDRS总分的合并MD及其95%CI为8.73 [2.88, 14.58]，P = 0.003。UPDRS III的合并MD及其95%CI为4.42 [3.23, 5.61]，P <.00001。UPDRS总分和UPDRS III的结果表明，与药物治疗相比，干预措施能更有效地降低PD患者的疾病严重程度和进展速度。
与对照组（药物治疗）相比，干预措施（SEA + 药物治疗）在PD患者的有效率、UPDRS总分和UPDRS III方面显示出显著疗效。然而，对韦伯斯特评分未显示出显著影响。
