乌梅丸加减治疗帕金森病的Meta分析及GRADE评价  

Meta-analysis and GRADE Evaluation of Modified Wumei Pill in the Treatment of Parkinson s Disease

作　　者：蔡燕珊 文晓东[2] 谭文澜[2] CAI Yan-shan;WEN Xiao-dong;TAN Wen-lan(Guangxi University of Traditional Chinese Medicine,Nanning 530001,China;Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning 530011,China)

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

出　　处：《云南中医中药杂志》2024年第8期24-32,共9页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：国家自然科学基金地区科学基金项目(82060888);广西中医药适宜技术开发与推广项目(GZSY22-32);崇左市科技计划项目(崇科FA2018027)。

摘　　要：目的 系统评估乌梅丸加减治疗帕金森病(parkinson's disease, PD)的疗效和安全性。方法 计算机检索Cochrane Library、EMBASE、Web of Science、PubMed、CNKI、CBM等中英文数据库及临床试验中心,关于乌梅丸治疗PD的临床随机对照试验(randomized controlled trial, RCT),检索时限从建库至2023年4月。进行资料整理及数据提取等工作后,最终纳入8项研究,治疗组(乌梅丸)和对照组分别纳入226例。使用RevMan 5.3及stata14软件进行荟萃分析,使用GRADEpro GDT评估各项结局指标的证据质量。结果 治疗组降低PD统一评分量表(unified Parkinson's disease rating scale, UPDRS)的各项量表积分较对照组明显,其中在改善UPDRS Ⅰ、Ⅲ、Ⅳ方面具有统计学意义,结果分别为[MD=-0.769,95%CI(-1.213~-0.324),P=0.001]、[MD=-2.211,95%CI(-2.713~-1.708),P=0]、[MD=-0.526,95%CI(-1.041~-0.012),P=0.045]。2组在改善UPDRS总分方面差异无统计学意义[MD=3.964,95%CI(-9.465~17.392),P=0.563]。治疗组能显著提高治疗有效率,差异具有统计学意义[RR=1.709,95%CI(1.361~2.145),P=0]。各项研究均未发现不良事件发生及与治疗有关的检验指标异常。GRADE证据质量分级结果为UPDRS Ⅰ、UPDRS Ⅲ、UPDRS Ⅳ及有效率方面均为中等级别,UPDRS Ⅱ为低等级,UPDRS总分为非常低。结论 乌梅丸加减的应用对PD的治疗有一定效果,且具有良好的安全性。Objective:To systematically evaluate the efficacy and safety of modified Wumei Pill in the treatment of parkinson s disease(PD).Methods:The randomized controlled trials(RCT)on the treatment of PD with Wumei Pill were searched in Cochrane Library,EMBASE,Web of Science,PubMed,CNKI and CBM databases and clinical trial centers,with the search time from database establishment to April 2023.After data collection and data extraction,8 studies were finally included.226 cases were included in the treatment group(Wumei Pill)and the control group,respectively.Meta-analyses were performed using RevMan 5.3 and stata14 software,and GRADEpro GDT was used to evaluate the quality of evidence for each outcome measure.Results:The scores of all scales of the unified Parkinson s disease rating scale(UPDRS)in the treatment group were significantly lower than those in the control group,and the improvements in UPDRS I,III and IV were statistically significant,with the results being[MD=-0.769,respectively.95%CI(-1.213~-0.324),P=0.001],[MD=-2.211,95%CI(-2.713~-1.708),P=0],[MD=-0.526,95%CI(-1.041~0.012),P=0.045].There was no significant difference in UPDRS score between the two groups[MD=3.964,95%CI(-9.465~17.392),P=0.563].The treatment group could significantly improve the treatment effective rate,and the difference was statistically significant[RR=1.709,95%CI(1.361-2.145),P=0].No adverse events or treatment-related abnormalities were found in any of the studies.GRADE evidence quality grading results were moderate in UPDRS I,UPDRS III,UPDRS IV and effective rate,low in UPDRS II,and very low in UPDRS total score.Conclusion:The modified Wumei Pill has a certain effect on the treatment of PD,and has good safety.

关 键 词：乌梅丸 帕金森病 META分析 GRADE评价 

分 类 号：R743[医药卫生—神经病学与精神病学]