中西医结合治疗帕金森病非运动症状的系统评价与Meta分析

Integrated traditional Chinese and western medicine for the Non-motor symptoms of parkinson's disease: a systematic review and meta-analysis

关键词:  帕金森病  非运动症状  中西医结合  系统评价  Meta分析

Key words:  parkinson's disease  non-motor symptoms  integrated Chinese and Western Medicine  systematic review  meta analysis

摘要:

[目的]系统评价中西医结合治疗帕金森病非运动症状的临床疗效与安全性。[方法]全面检索相关中英文数据库，搜集自建库至2018年7月所有中药联合西医基础治疗与西医基础治疗（和中药安慰剂）的临床随机对照试验，根据纳入标准、排除标准，选择符合标准的相关文献并提取资料，依据Cochrane Handbook对纳入的文献进行质量评价，并采用RevMan5.3软件进行Meta分析。[结果]最终纳入24篇RCT，共计1 836例患者，分别采用主要指标及次要指标进行评价。结果显示：NMSS量表[MD=-6.19，95% CI=（-7.68，-4.69），Chi²=0.83，DF=3，n=302]；NMS-Quest量表[MD=-2.17，95% CI=（-2.67，-1.68），n=601]UPDRS I量表，未进行Meta分析[Chi²=75.91，DF=10，n=882]，UPDRS Ⅱ量表[MD=-2.71，95% CI=（-3.34，-2.08），n=1164]；PDQ-39量表[MD=-7.81，95% CI=（-9.97，-5.64），n=407]。[结论]中西医结合治疗帕金森病非运动症状有效，且优于单纯西医基础治疗。

Abstract:

[Objective] To systematicallyevaluate the efficacy and safety ofintegrated Chinese and Western medicine in the treatment ofnon-motor symptomsof Parkinson's disease.[Methods] The Chinese and English databases were searched comprehensively. Self-built library to collect all in June,2018 traditional Chinese medicine with western medicine treatment with western medicine basis therapy (and Chinese medicineplacebo) clinical randomized controlled trials. According to the inclusion criteria and exclusion criteria,choose to conform to the standards of the related literature and extract data,on the basis of the Cochrane faced to quality assessment of included in the literature. And Meta-analysis was performed using RevMan5.3 software.[Results] A total of 1 836 patients were included in 24 RCT articles,and the main indicators and secondary indicators were used for evaluation. The results showed:NMSS scale[MD=-6.19,95% CI=(-7.68,-4.69),Chi²=0.83,DF=3,P<0.000 01,n=302];NMS-Quest scale[MD=-2.17,95% CI=(-2.67,-1.68),P<0.000 01,n=601] UPDRS I scale,no meta-analysis[Chi²=75.91,DF=10,P=0.0002<0.05,n=882],UPDRS Ⅱ Scale[MD=-2.71,95% CI=(-3.34,-2.08),P<0.000 01,n=1 164];PDQ-39 scale[MD=-7.81,95% CI=(-9.97,-5.64)),P<0.000 01,n=407].[Conclusion] From the analysis of current evidences,the combination of Chinese and western medicine in the treatment of non-movement symptoms of Parkinson's disease is effective and superior to the simple basic treatment of western medicine,but due to the limitations of literature quality,further studies are needed to demonstrate.