基于Meta分析的艾灸治疗帕金森病疗效研究

Moxibustion for Parkison Disorder:A Systematic Review and Meta-analysis

目的:采用Meta分析评价艾灸改善帕金森病临床症状的疗效。方法:检索CNKI、Wanfang、VIP、CBM、Pubmed、Web of science及the Cochrane Central Register of Controlled Trials等数据库,检索艾灸或艾灸联合西药治疗帕金森病的随机对照临床研究,截止至2015年12月1日。采用RevMan 5.3进行统计分析。结果:共纳入5个临床研究,患者402例,RevMan偏倚风险评价显示文献质量普遍较低。Meta分析显示:与西药治疗方法相比,艾灸结合西药疗法在改善UPDRS-运动功能分项、总有效率及显效率方面,疗效差异具有统计学意义,Meta结果分别为(MD=-0.34,95%CI[-0.63,-0.05],P=0.02)、(RR=1.27,95%CI[1.15,1.40],P<0.000 01)、(RR=1.60,95%CI[1.23,2.07],P=0.000 4);在改善UPDRS量表总分及精神、行为和情绪、日常生活活动、并发症等方面,疗效差异无统计学意义,Meta结果分别为:(MD=-0.08,95%CI[-0.95,-0.60],P=0.65)、(MD=0.06,95%CI[-0.23,0.34],P=0.69)、(MD=-0.17,95%CI[-1.54,1.21],P=0.81)、(MD=-0.53,95%CI[-2.09,1.03],P=0.50)。结论:艾灸可能是一种改善帕金森病病情的有效疗法,尤其在运动功能方面,但仍需更多高质量的证据支持。

Objective：To assess the efficacy of moxibustion for Parkison disorder. Methods：We comprehensively searched CNKI, Wanfang, VIP, CBM, Pubmed, Web of science, and the Cochrane Central Register of Controlled Trials databases for the randomized-controlled trials without language restrictions up to December 1st, 2015. And we performed a cumulative meta-analysis of all randomized controlled trails with RevMan5.3. Results： 5 studies with 402 participants were included but the quality of which were low. The results showed that, compared to western medicine therapy, patient in the experiment group might benefit from better UPDRS-motor examination score, total effective rate, and effective rate （MD=- 0.34,95% CI [-0. 63 ,-0.05], P= 0.02）, （RR=1.27,95%CI [-1.15,1.40],P〈0. 000 01）,（RR=I. 60,95% CI [-1.23,2.07],P=0. 000 4） ; and might not benefit from UPDRS total stole, UPDRS-mentation, behavior and mood score, UPDRS-activities of daily living score and complications of therapy（（MD= -0. 08,95%CI [-0. 95, -0.60],P=0.65）,（MD=0.06,95%CI [-0.23, 0.34],P=0.69）,（MD=-0.17,95%CI [-1.54, 1.21],P=0.81）,（MD=0.53,95%CI [-2.09, 1.03],P=0.50））. Conclusion：The data suggests that moxibustion may be a useful therapy for Parkison disorder, especially on the motor function. However, because of the lower methodological quality of studies, there certainly is a further need for higher quality trials in this area.