针刺治疗帕金森病临床疗效的Meta分析  

A meta-analysis on clinical effect of acupuncture for Parkinson disease

作　　者：刘艳慧[1] 陈涛[1] 邓益东[1] 张杉 滕思 蔡奔驰 苏佳丽 

机构地区：[1]海南省人民医院神经内科,海口570311

出　　处：《中国医师杂志》2018年第1期16-23,27,共9页Journal of Chinese Physician

基　　金：国家自然科学基金(81060096;81560202);海南省重点科研课题项目(14A110060);海南省应用技术研发与示范推广专项项目(ZDXM2015067)~~

摘　　要：目的运用循证医学方法系统评价针刺治疗帕金森病的临床疗效。方法通过检索中国期刊全文数据库(CNKI)、万方、维普、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library等数据库,搜索自建库至2017年5月已发表的关于针刺治疗帕金森病临床疗效的随机对照试验相关文献,根据Cochrane协作网系统评价手册(5.1.0版)提供的偏倚风险评估工具对纳入文献进行质量评价和资料提取,采用RevMan 5.3软件进行Meta分析。对比分析观察组(针刺或针药联合治疗)与对照组(抗帕金森病药物治疗)的临床总有效率、各量表积分情况、运动症状改善情况等指标,评价针刺治疗帕金森病的临床获益。结果共纳入12篇符合标准的随机对照试验文献,总计892例患者,其中观察组468例,对照组424例。Meta分析结果显示:观察组临床总有效率显著优于对照组,差异有统计学意义[OR=2.16,95%CI(1.57,2.97),P<0.01];针刺治疗前后UPDRS总评分及改良Webster量表积分改善情况均显著优于对照组,差异有统计学意义[OR=7.20,95%CI(4.02,10.37),P<0.01;OR=3.33,95%CI(2.13,4.53),P<0.01]。其中,对帕金森病运动症状针刺治疗前后改善情况进行分析,发现观察组在改善肌强直、姿势步态、运动迟缓等方面优于对照组,差异有统计学意义(P<0.05),而在静止性震颤方面观察组与对照组差异无统计学意义(P>0.05)。结论针刺治疗帕金森病的临床疗效确切,可在一定程度上改善帕金森病患者临床症状,延缓病情进展,提高患者生存质量,推荐在临床上广泛运用。Objective To evaluate the clinical effect of acupuncture on Parkison disease （PD） with systematic review in view of evidence-based medicine （EBM）. Methods Articles on clinical effect of acupuncture on Parkinson disease published from the database-established year to May of 2017 we searched from China National Knowledge Internet （CNKI）, Wanfang, VIP, Chinese Biomedical Literature Database （CBM） , PubMed, and Coehrane Library databases without language limitation. Quality evaluation and data extraction were carried out according to the tool for assessing risk of bias provided by the Coehrane Hand- book for Systematic Reviews of Interventions （ Version 5.1.0）. All statistical analyses were performed with Reviewer Manager Software （Version 5.3 ; Cochrane Collaboration, Oxford, UK）. Assessments were per- formed with the total effective rate, the scores of each scale （ the unified Parkinson disease rating scales-UP- DRS and the Webster scale） , and the improvement of different clinical manifestation. Results In all, 12 randomized controlled trials （RCTs） met our inclusion criterion, a total of 892 patients, including 468 cases in the experimental group （aeupunctuer with or without medicine） and 424 cases in the control group （med- icine only）. Meta-analysis showed favorable results for the experimental group compared to control group in the total effective rate, the total scales of UPDRS and the modified Webster scale [ OR = 2. 16, 95% CI （1.57,2.97）,P〈0.01; OR =7.20, 95% CI（4.02,10.37）, P〈O. O1;OR=3.33, 95% CI（2.13, 4. 53 ） , P 〈 0. 011. The experimental group was effective in relieving partial symptoms of PD such as rigidi- ty, postural, gait, bradykinesia compared to the control group, while there was no significant difference in tremor at rest and sit-stand up movements （ P 〉 0. 05 ）. Conclusions Acupuncture had certain clinical effect on Parkinson disease, it can relieve the clinical symptoms of Parkinson disease to some extent, and postpone the pro

关 键 词：针刺疗法 帕金森病/针灸疗法 META分析 

分 类 号：R246.6[医药卫生—针灸推拿学]