中药联合西医常规治疗帕金森病伴轻度认知功能障碍的临床有效性及安全性的Meta分析  

Clinical Efficacy and Safety of Chinese Medicine Combined with Western Conventional Medicine for the Treatment of Parkinson’s Disease with Mild Cognitive Impairment:A Meta-analysis

作　　者：甘盼盼 刘玲 全毅红[2] GAN Pan-Pan;LIU Ling;QUAN Yi-Hong(Clinical School of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430065 Hubei,China;Dept.of Traditional Chinese Medicine,the Central Hospital of Wuhan Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430014 Hubei,China)

机构地区：[1]湖北中医药大学中医临床学院,湖北武汉430065 [2]华中科技大学同济医学院附属武汉市中心医院中医科,湖北武汉430014

出　　处：《广州中医药大学学报》2022年第8期1938-1946,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:81273648);武汉市卫生健康委青年项目(编号:WZ19Q05)。

摘　　要：【目的】系统评价中药联合西医常规治疗帕金森病伴轻度认知功能障碍(PD-MCI)的临床有效性及安全性。【方法】通过计算机检索国内外相关数据库中关于中药联合西医常规(治疗组)对比西医常规(对照组)治疗PD-MCI的临床随机对照试验(RCTs),根据纳入及排除标准进行文献筛选。采用Cochrane系统评价手册的偏倚风险评价工具对所纳入的文献进行质量评价,采用Review Manager 5.3软件对所提取的数据进行Meta分析。【结果】共纳入10项RCTs。Meta分析结果显示:与西医常规治疗比较,中药联合西医常规治疗帕金森病伴轻度认知功能障碍能显著提高患者的临床有效率(RR=1.33,95%CI[1.10,1.60]),降低帕金森病统一评分量表(UPDRS)总分(MD=-7.12,95%CI[-10.23,-4.00])、UPDRS-Ⅱ量表评分(MD=-2.54,95%CI[-3.75,-1.33])、UPDRS-Ⅲ量表评分(MD=-2.77,95%CI[-4.63,-0.91]),提高蒙特利尔认知评估量表(MoCA)评分(MD=3.14,95%CI[2.25,4.02])、简易智力精神状态检查量表(MMSE)评分(MD=2.77,95%CI[1.93,3.60]),减少左旋多巴用量(MD=-111.20,95%CI[-136.34,-86.06]),且不良反应发生率较低(RR=0.43,95%CI[0.27,0.69])。【结论】中药联合西医常规治疗PD-MCI有效且安全性较高。Objective To systematically evaluate the clinical efficacy and safety of Chinese medicine(CM)combined with conventional western medicine for the treatment of Parkinson’s disease with mild cognitive impairment(PD-MCI).Methods Clinical randomized controlled trials(RCTs)of PD-MCI treated by CM combined with conventional western medicine(treatment group)compared with conventional western medicine alone(control group)in relevant databases at home and abroad were retrieved by computer,and the literature was screened according to the inclusion and exclusion criteria.The quality of the literature was evaluated with tools for analysis of bias recommended by Cochrane Reviewer’s Handbook,and meta-analysis of the extracted data was carried out using Review Manager 5.3 software.Results A total of 10 RCTs were included.Meta-analysis results showed that in comparison with conventional western medicine,CM combined with conventional western medicine can significantly improve the clinical effective rate(RR=1.33,95%CI[1.10,1.60]),reduce the total scores of Unified Parkinson’s Disease Rating Scale(UPDRS)(MD=-7.12,95%CI[-10.23,-4.00]),UPDRS-Ⅱscores(MD=-2.54,95%CI[-3.75,-1.33])and UPDRS-Ⅲscores(MD=-2.77,95%CI[-4.63,-0.91]),improve Montreal Cognitive Assessment(MoCA)scores(MD=3.14,95%CI[2.25,4.02])and Mini-mental State Examination(MMSE)scores(MD=2.77,95%CI[1.93,3.60]),and reduce levodopa dosage(MD=-111.20,95%CI[-136.34,-86.06]),and the incidence of adverse reaction was low(RR=0.43,95%CI[0.27,0.69]).Conclusion CM combined with conventional western medicine is effective and safe for the treatment of PD-MCI.

关 键 词：帕金森病 轻度认知功能障碍 中药疗法 有效率 帕金森病统一评分量表(UPDRS)评分 蒙特利尔认知评估量表(MoCA)评分 简易智力精神状态检查量表(MMSE)评分 META分析 

分 类 号：R256.46[医药卫生—中医内科学] R742.5[医药卫生—中医学]