中医药治疗帕金森病疗效系统评价  

Chinese Medicine Treatment for Parkinson Disease:A Systematic Review

作　　者：文晓东[1] 郑景辉[1] 蒙冰[1] 张跃龄[1] 王春玲[2] 

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011 [2]广西中医药大学,广西南宁530001

出　　处：《辽宁中医药大学学报》2014年第7期120-124,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广西自然基金项目(2012GXNSFAA053076)

摘　　要：目的：系统评价中药联合帕金森病基础西药与西药比较以及单纯中药疗法与西药比较治疗帕金森病的有效性与安全性。方法：通过检索Cochrane Database、EMbase、PubMed、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊全文数据库（VIP）、万方数据库,全面收集中药联合帕金森病基础西药以及单纯中药疗法治疗帕金森病的中英文随机对照试验（RCT）,检索时限截至2012年12月。由2名评价者独立评价并交叉核对纳入研究质量后,对同质研究采用RevMan 5.0.20软件进行Meta分析。结果：共纳入17项随机对照试验（RCT）研究,包括1461例患者,Meta分析结果显示：（1）UPDRS评分变化：13项研究在治疗末应用UPDRS进行评分,UPDRS总分[WMD=5.95,95%CI（4.37~7.42）]、UPDRS II[WMD=2.13,95%CI（1.62~2.64）]、UPDRS III[WMD=1.95,95%CI（0.81~2.42）]和UPDRS IV[WMD=0.64,95%CI（0.32~0.97）]分值相对于基线评分,中药联合帕金森病基础西药组均较对照组明显下降,两组之间差别有统计学意义;4项研究评价单纯中药疗法,治疗末应用UPDRS量表总分和UPDRSⅢ进行评分,中药治疗组与西药组比较在总体疗效、运动症状改善方面,差异无统计学意义。（2）治疗有效率：4项研究采用UPDRS减分率计算有效率的Meta分析结果显示,中药联合帕金森病基础西药组治疗有效率优于对照组[RR=1.52,95%CI（1.28~1.82）]。2个研究采用UPDRS减分率计算有效率的Meta分析结果显示,中药组与西药组的治疗有效率比较,差异无统计学意义[RR=1.01,95%CI（0.86~1.18）]。（3）不良反应：共7个试验报道了药品不良事件,无严重不良事件发生。结论：中医药治疗帕金森病安全、有效。中药联合帕金森病基础西药可能优于单用西药;对于早期帕金森病患者,采用单纯中药治疗与西药（美多巴）疗效相当。但因纳入文献数量有限且部分研究质量较�Objective ： To assess the efficacy and safety of combination of Chinese and western medicine versus western drugs or Chinese medicine versus western drugs in the treatment of Parkinson disease. Methods ： Through adopting Cochrane systematic review methods, the relevant materials were retrieved by searching Cochrane Database, EMbase, PubMed, CBM, CNKI, VIP and Wanfang databases, so as to collect the randomized controlled trials （ RCTs ） involving combination of Chinese and western medicine and Chinese medicine alone in the treatment of Parkinson disease, which were searched by the end of December 2012. The quality of each trial was assessed by two reviewers independently, and Meta-analysis was conducted by using RevMan 5.0.20 software. Results： 17 RCTs involving 1461 patients were included. The result of Meta-analyses indicated that combination of Chinese and western medicine was associated with a significant reduction in the scores of total UPDRS （ WMD=5.95,95%CI 4.37 to 7.42 ）, UPDRS Ⅱ （ WMD=2.13,95% CI 1.62 to 2.64 ）, UPDRS Ⅲ（ WMD=1.95,95%CI 0.81 to 2.42 ）and UPDRS IV （ WMD=0.64,95% CI 0.32 to 0.97 ）. Concerned with total effective rates and the movement symptoms, there were no significant differences between Chinese medicine and Madopargroups. Meta-analysis of 4 trials, in which effective rates were assessed by UPDRS, suggesting that there were significant differences between combination of Chinese and western medicine and western drugs during the treatment period （ RR=1.52, 95%CI 1.28 to 1.82 ）. Concerned with effective rates, the efficacy of the Chinese medicine and Madopar groups were equal （RR=1,01,95%CI 0.86 to 1.18 ）. Adverse events were reported in 7 trials. However, no severe adverse events were reported. Conclusion ： Chinese medicine is safe and effective in the treatment of Parkinson disease. Chinese medicine plus western drugs may be superior to western drugs alone. The usage of Chinese medicine simply was safe and effective in the treatment of early PD patien

关 键 词：中医药治疗 帕金森病 META分析 系统评价 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]