针灸干预帕金森病的系统评价再评价

Report and quality anal Acupuncture and moxibustion for Parkinson’s disease:an overview of systematic reviewsysis of health technology assessment

目的对针灸干预帕金森病的系统评价和Meta分析(SR/MA)的结果进行总结与归纳,并对纳入研究的方法学、报告及证据质量进行评价。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、EMbase、Cochrane Library和Web of Science数据库,搜集针灸干预帕金森病的SRs/MAs,检索时限均为建库至2023年5月1日。使用AMSTAR 2、PRISMA和GRADE工具对纳入的SR/MA的方法学质量、报告质量和证据质量进行总结和评估。结果共纳入28篇SRs/MAs,纳入研究结论显示针灸干预帕金森病具有临床疗效优势。28篇研究的方法学质量均为极低。13篇研究的报告相对完整,14篇报告有一定缺陷,1篇报告有相对严重的缺陷。对7个结局指标的126次报告中有56项为极低质量,57项为低质量,12项为中等质量,1项为高质量。结论现有研究显示针灸干预帕金森病具有一定临床疗效,但相关SR/MA的方法学质量及证据质量较低,规范性仍有待提高,未来仍需开展高质量临床研究验证。

Objective To summarize and evaluate the quality of methodology,report and evidence of the systematic reviews and meta-analyses(SRs/MAs)of acupuncture and moxibustion interventions for Parkinson's disease.Methods Eight databases including CNKI,WanFang Data,VIP,CBM,PubMed,EMbase,Cochrane Library and Web of Science were searched from inception to May 1,2023.The quality of methodology,report and evidence involved in these studies were evaluated by AMSTAR 2,PRISMA and GRADE tool.Results A total of 28 SRs/MAs were included,and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease.The methodological quality of all studies was extremely low.Thirteen reports were relatively complete,14 reports had certain flaws,and 1 report had relatively serious flaws.And of the 126 reports for seven outcomes,1 was graded as high,12 as moderate,57 as low,and 56 as critically low.Conclusion The current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease,but the methodological quality and evidence quality of related SRs/MAs are low,and the standardization still needs to be improved.The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.