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穴位疗法与传统药物联合治疗帕金森病非运动症状的系统评价与Meta分析

Combination treatment with acupoint therapy and conventional medication for non-motor symptoms in Parkinson's disease: a systematic review and meta-analysis.

作者信息

Hu Wenjiao, Zhou Hao, Zhu Wenwen, Xie Songcheng, Zeng Yue, Wang Zhengyan

机构信息

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Sichuan Integrative Medicine Hospital, Chengdu, China.

出版信息

Front Neurol. 2025 May 22;16:1381500. doi: 10.3389/fneur.2025.1381500. eCollection 2025.

DOI:10.3389/fneur.2025.1381500
PMID:40474920
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12137075/
Abstract

BACKGROUND: Managing Parkinson's non-motor symptoms (PD-NMS) is challenging. Traditional methods have limited efficacy for NMS. Acupoint therapy offers a safe and personalized option. There has been a growing number of studies on acupoint therapies for PD-NMS. However, a systematic review of their effectiveness and safety is currently not available. Therefore, this study aims to evaluate the effectiveness and safety of acupoint therapy for PD-NMS. METHODS: PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and Chinese Biomedical Literature Database were searched. Data were analyzed using fixed or random effects models. Randomized controlled trials (RCT) in Chinese and English relating to acupoint therapy for NMS in PD (PD-NMS), individuals diagnosed with PD, primary and secondary outcome measures are HAMD, MMSE, MoCA, PDSS, PSQI were included. Cochrane risk-of-bias tool (ROB 2) for RCT was used. Meta-analyses were performed to calculate the RR and WMD. Subgroup analyses, sensitivity analyses, and funnel plot analyses were conducted. RESULTS: Forty-two studies (3120 PD-NMS patients) from database establishment to May 2023 were included. According to the ROB 2 evaluation, risks of bias in random sequence generation, missing data and selective reporting were low, moderate in allocation concealment, and high in blinding. Acupoint therapy combined with CM or NDT was more effective than single-therapy in most outcome measures like effective rate, HAMD, MoCA, PDSS and PSQI, but the MMSE difference was non-significant. CONCLUSION: Due to the large number of research subjects, differences in the severity of the diseases, and possible variations of the intervention details, there is a certain degree of heterogeneity in the research results. However, acupoint therapy or acupoint therapy combined with CM could be an option for the treatment of PD-NMS in the future. SYSTEMATIC REVIEW REGISTRATION: This review protocol has been registered in PROSPERO (ID: CRD42023426305). https://www.crd.york.ac.uk/PROSPERO/.

摘要

背景：帕金森病非运动症状（PD-NMS）的管理具有挑战性。传统方法对非运动症状的疗效有限。穴位疗法提供了一种安全且个性化的选择。关于PD-NMS穴位疗法的研究越来越多。然而，目前尚无对其有效性和安全性的系统评价。因此，本研究旨在评估穴位疗法治疗PD-NMS的有效性和安全性。 方法：检索了PubMed、Web of Science、Cochrane图书馆、Embase、中国知网、万方数据库、中国科技期刊数据库和中国生物医学文献数据库。使用固定或随机效应模型分析数据。纳入了中文和英文的随机对照试验（RCT），这些试验涉及PD中NMS的穴位疗法（PD-NMS）、诊断为PD的个体，主要和次要结局指标为汉密尔顿抑郁量表（HAMD）、简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、帕金森病睡眠量表（PDSS）、匹兹堡睡眠质量指数（PSQI）。使用Cochrane随机对照试验偏倚风险工具（ROB 2）。进行荟萃分析以计算风险比（RR）和加权均数差（WMD）。进行亚组分析、敏感性分析和漏斗图分析。 结果：纳入了从数据库建立到2023年5月的4项研究（3120例PD-NMS患者）。根据ROB 2评估，随机序列生成、数据缺失和选择性报告方面的偏倚风险较低，分配隐藏方面为中度，而盲法方面为高度。在大多数结局指标如有效率、HAMD、MoCA、PDSS和PSQI方面，穴位疗法联合中药或非药物治疗比单一疗法更有效，但MMSE差异无统计学意义。 结论：由于研究对象数量众多、疾病严重程度不同以及干预细节可能存在差异，研究结果存在一定程度的异质性。然而，穴位疗法或穴位疗法联合中药可能是未来治疗PD-NMS的一种选择。 系统评价注册：本评价方案已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42023426305）。https://www.crd.york.ac.uk/PROSPERO/ 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/7f2ebb517e0a/fneur-16-1381500-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/19bd65a58c87/fneur-16-1381500-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/9dfd4423c7c8/fneur-16-1381500-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/5b123522a3a8/fneur-16-1381500-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/cf530e7d721f/fneur-16-1381500-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/f60927eb64bd/fneur-16-1381500-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/7f2ebb517e0a/fneur-16-1381500-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/19bd65a58c87/fneur-16-1381500-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/81a0f6689e8c/fneur-16-1381500-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/36e91a811978/fneur-16-1381500-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/9dfd4423c7c8/fneur-16-1381500-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/5b123522a3a8/fneur-16-1381500-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/cf530e7d721f/fneur-16-1381500-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/e295112de759/fneur-16-1381500-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/a84b9f6f28f7/fneur-16-1381500-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/f60927eb64bd/fneur-16-1381500-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/12137075/7f2ebb517e0a/fneur-16-1381500-g012.jpg

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本文引用的文献

[1]
Qualitative and quantitative meta-analysis of acupuncture effects on the motor function of Parkinson's disease patients.

Front Neurosci. 2023-5-9

[2]
Effect of Physiotherapy Interventions on Motor Symptoms in People With Parkinson's Disease: A Systematic Review and Meta-Analysis.

Biol Res Nurs. 2023-10

[3]
Effect of acupuncture for non-motor symptoms in patients with Parkinson's disease: A systematic review and meta-analysis.

Front Aging Neurosci. 2022-10-6

[4]
Can spa rehabilitative interventions play a role for patients suffering from neurodegenerative disorders at the early stages? A scoping review.

Int J Biometeorol. 2022-12

[5]
Parkinson's Disease: A Multisystem Disorder.

Neurosci Bull. 2023-1

[6]
Acupuncture for cancer-related insomnia: A systematic review and meta-analysis.

Phytomedicine. 2022-7-20

[7]
Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson's disease patients.

Transl Neurodegener. 2022-2-7

[8]
Clinical and imaging evidence of brain-first and body-first Parkinson's disease.

Neurobiol Dis. 2022-3

[9]
The neuropsychiatry of Parkinson's disease: advances and challenges.

Lancet Neurol. 2022-1

[10]
Effectiveness of Telerehabilitation on Motor Impairments, Non-motor Symptoms and Compliance in Patients With Parkinson's Disease: A Systematic Review.

Front Neurol. 2021-8-26

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