Objective:To summarize the current clinical evidence related to the therapeutic effects and safety of adjuvant scalp electro-acupuncture (SEA) treatment for Parkinson's disease in China.Methods:Following the PRISM...Objective:To summarize the current clinical evidence related to the therapeutic effects and safety of adjuvant scalp electro-acupuncture (SEA) treatment for Parkinson's disease in China.Methods:Following the PRISMA statement,seven electronic databases were searched to retrieve randomized controlled clinical trials that used SEA combined with medication as the treatment intervention,and medication as the control.RevMan 5.3 was used to analyze outcomes,including the Unified Parkinson's Disease Rating Scale (UPDRS),Webster scale,effectiveness rate,and UPDRS III.Results:Nine randomized controlled trials,with certain methodological flaws and risks of bias,were included that involved 474 participants.SEA combined with medication was more effective than medication alone in overall therapeutic effects,as evidenced by total UPDRS scores (mean difference (MD):7.15,95% confidence interval [CI] 0.24 to 14.07,P =.04),Webster scores (MD:1.60,95% CI 0.20 to 2.99,P =.03),and effectiveness rate (risk ratio:1.35,95% CI 1.19 to 1.54,P <.001).In addition,there was significant improvement in pooled motor function results after adjuvant SEA treatment compared with medication alone (MD:5.75,95% Cl 4.18 to 7.32,P <.001).Conclusion:The combination of SEA and medication may be a promising intervention for patients with Parkinson's disease,especially to improve motor function.However,results were inconclusive,and additional studies with rigorous experimental design and larger sample sizes are needed to verify these results.展开更多
Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopam...Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson＇s disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson＇s disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi ＂Bonino-Pulejo＂ （Messina）, were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale （UPDRS-Ⅲ） scores, the Parkinson Disease Questionnaire-39 Item scores （as a disease-specific measure of health-related quality of life）, scores on the Short Form （36） Health Survey Questionnaire （as a generic measure）, and answers to a brief checklist were recorded. A total of 85 Parkinson＇s disease patients （49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years） completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.展开更多
Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,an...Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,and mecha-nisms of action in Parkinson’s disease(PD)during extended use has not been evaluated.Methods As a primary goal,safety and tolerability was assessed in five PD patients treated with sargramostim(Leukine®,granulocyte-macrophage colony-stimulating factor)for 33 months.Secondary goals included numbers of CD4+T cells and monocytes and motor functions.Hematologic,metabolic,immune,and neurological evaluations were assessed during a 5-day on,2-day off therapeutic regimen given at 3μg/kg.After 2 years,drug use was discon-tinued for 3 months.This was then followed by an additional 6 months of treatment.Results Sargramostim-associated adverse events included injection-site reactions,elevated total white cell counts,and bone pain.On drug,blood analyses and metabolic panels revealed no untoward side effects linked to long-term treatment.Unified Parkinson’s Disease Rating Scale scores remained stable throughout the study while regulatory T cell number and function were increased.In the initial 6 months of treatment,transcriptomic and proteomic mono-cyte tests demonstrated autophagy and sirtuin signaling.This finding paralleled anti-inflammatory and antioxidant activities within both the adaptive and innate immune profile arms.Conclusions Taken together,the data affirmed long-term safety as well as immune and anti-inflammatory responses reflecting clinical stability in PD under the sargramostim treatment.Confirmation in larger patient populations is planned in a future phase II evaluation.展开更多
目的运用网状meta分析探讨血管性帕金森综合征(vascular parkinsonism,VP)药物治疗的疗效及安全性。方法计算机检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed、Web of Science、MEDLINE、Embase、Cochrane Librar...目的运用网状meta分析探讨血管性帕金森综合征(vascular parkinsonism,VP)药物治疗的疗效及安全性。方法计算机检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed、Web of Science、MEDLINE、Embase、Cochrane Library收录的VP药物治疗的随机对照试验,检索时限为各数据库建库至2023年1月1日。由两名研究员独立进行文献筛选、数据提取并对纳入的研究进行质量评价,应用R软件对数据进行网状meta分析。结果最终纳入20项研究,包括丁苯酞联合多巴丝肼、依达拉奉联合多巴丝肼、盐酸普拉克索联合多巴丝肼、单用多巴丝肼4种药物疗法。总体文献质量水平中等。网状meta分析结果显示:(1)在治疗总有效率方面,优选概率排名曲线(surface under the cumulative ranking curve,SUCRA)排序结果显示,丁苯酞联合多巴丝肼>依达拉奉联合多巴丝肼>盐酸普拉克索联合多巴丝肼>单用多巴丝肼;(2)在帕金森病统一评分量表(unified Parkinson’s disease rating scale,UPDRS)评分改善方面,SUCRA排序结果显示,丁苯酞联合多巴丝肼>依达拉奉联合多巴丝肼>盐酸普拉克索联合多巴丝肼>单用多巴丝肼;(3)在不良反应方面,SUCRA排序结果显示,丁苯酞联合多巴丝肼>单用多巴丝肼>盐酸普拉克索联合多巴丝肼>依达拉奉联合多巴丝肼。结论丁苯酞联合多巴丝肼治疗VP的有效率最高,对UPDRS评分改善最明显,且安全性最好,未观察到有明显增加不良反应的风险。但纳入的研究方法学质量普遍偏低,故结论仍待更多大样本、高质量的研究进一步验证。展开更多
基金the National Natural Science Foundation of China(81573773 and 81774110)Self-determined Project of Beijing University of Chinese Medicine(2017-JYB-JS-004).
文摘Objective:To summarize the current clinical evidence related to the therapeutic effects and safety of adjuvant scalp electro-acupuncture (SEA) treatment for Parkinson's disease in China.Methods:Following the PRISMA statement,seven electronic databases were searched to retrieve randomized controlled clinical trials that used SEA combined with medication as the treatment intervention,and medication as the control.RevMan 5.3 was used to analyze outcomes,including the Unified Parkinson's Disease Rating Scale (UPDRS),Webster scale,effectiveness rate,and UPDRS III.Results:Nine randomized controlled trials,with certain methodological flaws and risks of bias,were included that involved 474 participants.SEA combined with medication was more effective than medication alone in overall therapeutic effects,as evidenced by total UPDRS scores (mean difference (MD):7.15,95% confidence interval [CI] 0.24 to 14.07,P =.04),Webster scores (MD:1.60,95% CI 0.20 to 2.99,P =.03),and effectiveness rate (risk ratio:1.35,95% CI 1.19 to 1.54,P <.001).In addition,there was significant improvement in pooled motor function results after adjuvant SEA treatment compared with medication alone (MD:5.75,95% Cl 4.18 to 7.32,P <.001).Conclusion:The combination of SEA and medication may be a promising intervention for patients with Parkinson's disease,especially to improve motor function.However,results were inconclusive,and additional studies with rigorous experimental design and larger sample sizes are needed to verify these results.
基金supported by a grant from the Ministry of Health (Research for the Strategic Program 2007)
文摘Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson＇s disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson＇s disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi ＂Bonino-Pulejo＂ （Messina）, were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale （UPDRS-Ⅲ） scores, the Parkinson Disease Questionnaire-39 Item scores （as a disease-specific measure of health-related quality of life）, scores on the Short Form （36） Health Survey Questionnaire （as a generic measure）, and answers to a brief checklist were recorded. A total of 85 Parkinson＇s disease patients （49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years） completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.
基金supported by National Institute of Neurological Disorders and Stroke Grant 5 R01NS034239-25 and private donations provided through the University of Nebraska Foundation.
文摘Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,and mecha-nisms of action in Parkinson’s disease(PD)during extended use has not been evaluated.Methods As a primary goal,safety and tolerability was assessed in five PD patients treated with sargramostim(Leukine®,granulocyte-macrophage colony-stimulating factor)for 33 months.Secondary goals included numbers of CD4+T cells and monocytes and motor functions.Hematologic,metabolic,immune,and neurological evaluations were assessed during a 5-day on,2-day off therapeutic regimen given at 3μg/kg.After 2 years,drug use was discon-tinued for 3 months.This was then followed by an additional 6 months of treatment.Results Sargramostim-associated adverse events included injection-site reactions,elevated total white cell counts,and bone pain.On drug,blood analyses and metabolic panels revealed no untoward side effects linked to long-term treatment.Unified Parkinson’s Disease Rating Scale scores remained stable throughout the study while regulatory T cell number and function were increased.In the initial 6 months of treatment,transcriptomic and proteomic mono-cyte tests demonstrated autophagy and sirtuin signaling.This finding paralleled anti-inflammatory and antioxidant activities within both the adaptive and innate immune profile arms.Conclusions Taken together,the data affirmed long-term safety as well as immune and anti-inflammatory responses reflecting clinical stability in PD under the sargramostim treatment.Confirmation in larger patient populations is planned in a future phase II evaluation.
文摘目的运用网状meta分析探讨血管性帕金森综合征(vascular parkinsonism,VP)药物治疗的疗效及安全性。方法计算机检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed、Web of Science、MEDLINE、Embase、Cochrane Library收录的VP药物治疗的随机对照试验,检索时限为各数据库建库至2023年1月1日。由两名研究员独立进行文献筛选、数据提取并对纳入的研究进行质量评价,应用R软件对数据进行网状meta分析。结果最终纳入20项研究,包括丁苯酞联合多巴丝肼、依达拉奉联合多巴丝肼、盐酸普拉克索联合多巴丝肼、单用多巴丝肼4种药物疗法。总体文献质量水平中等。网状meta分析结果显示:(1)在治疗总有效率方面,优选概率排名曲线(surface under the cumulative ranking curve,SUCRA)排序结果显示,丁苯酞联合多巴丝肼>依达拉奉联合多巴丝肼>盐酸普拉克索联合多巴丝肼>单用多巴丝肼;(2)在帕金森病统一评分量表(unified Parkinson’s disease rating scale,UPDRS)评分改善方面,SUCRA排序结果显示,丁苯酞联合多巴丝肼>依达拉奉联合多巴丝肼>盐酸普拉克索联合多巴丝肼>单用多巴丝肼;(3)在不良反应方面,SUCRA排序结果显示,丁苯酞联合多巴丝肼>单用多巴丝肼>盐酸普拉克索联合多巴丝肼>依达拉奉联合多巴丝肼。结论丁苯酞联合多巴丝肼治疗VP的有效率最高,对UPDRS评分改善最明显,且安全性最好,未观察到有明显增加不良反应的风险。但纳入的研究方法学质量普遍偏低,故结论仍待更多大样本、高质量的研究进一步验证。
