针灸治疗帕金森病相关性便秘:系统回顾和荟萃分析

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE European Journal of Integrative Medicine Pub Date : 2024-01-01 DOI:10.1016/j.eujim.2024.102332
Xin-Xin Feng , Lei Chen , Yong-Yi Xu , Kai Zhou , Kai-Yu Huang
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引用次数: 0

摘要

简介:帕金森病相关性便秘(PDC)的危害不容忽视。针灸有望成为治疗帕金森病的主流方法。本综述旨在研究针灸对 PDC 的影响,从而为临床应用提供循证建议。方法检索了六个数据库中有关针灸治疗 PDC 的随机对照试验(RCT)。主要结果为应答率。次要结果为直肠静止压、肛门静止压、肛门最大收缩压、直肠感觉阈值、直肠最大耐受量、便秘评分系统(CSS)评分、便秘患者生活质量评估(PAC-QOL)评分以及不良事件(AEs)。方法学质量普遍较低。针灸与药物(95%CI= 1.09 至 1.54,P=0.003)或空白对照(95%CI= 1.04 至 1.74,P=0.02)相比,反应率有明显差异,而针灸+药物与药物相比则无明显差异。与药物相比,针灸+药物对直肠静息压、肛门静息压、肛门最大收缩压、直肠感觉阈值和直肠最大耐受量有显著影响,而针灸与药物相比则无显著影响。针灸与空白对照时,CSS 评分有明显差异;针灸与假药或空白对照时,PAC-QOL 评分有明显差异,而针灸与药物对照时,PAC-QOL 评分无明显差异。结论针灸可能是治疗 PDC 的有效方法。由于证据质量有限,应进行高水平、多中心、大样本量的 RCT 研究。
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Acupuncture for Parkinson's disease-related constipation: A systematic review and meta-analysis

Introduction

The hazard of Parkinson's disease-related constipation (PDC) cannot be ignored. Acupuncture has the potential to become a mainstream treatment option for PDC. This review aimed to investigate the effect of acupuncture on PDC, which might provide evidence-based recommendations for clinical application.

Methods

Six databases were searched for randomized controlled trials (RCTs) about acupuncture for PDC. The primary outcome was response rate. The secondary outcomes were rectal resting pressure, anal resting pressure, anal maximum contraction pressure, rectal sensation threshold, rectal maximum tolerable volume, the Constipation Scoring System (CSS) score, the Patient Assessment of Constipation Quality of Life (PAC-QOL) score, and adverse events (AEs).

Results

Eight trials involving 591 participants were included. The methodological quality was generally low. A significant difference was found in response rate when comparing acupuncture with medicine (95 %CI= 1.09 to 1.54, P = 0.003) or blank control (95 %CI= 1.04 to 1.74, P = 0.02), while no significant difference was observed when comparing acupuncture + medicine with medicine. Acupuncture + medicine did have a significant effect on rectal resting pressure, anal resting pressure, anal maximum contraction pressure, rectal sensation threshold and rectal maximum tolerable volume when compared with medicine, while no significant effect was found when acupuncture was compared with medicine. A significant difference was found in the CSS score when acupuncture was compared with blank and in the PAC-QOL score when acupuncture was compared with sham or blank, while no significant difference was found in the PAC-QOL score when acupuncture was compared with medicine. One study reported mild AEs.

Conclusions

Acupuncture might be an effective treatment for PDC. Due to the limited quality of evidence, high-caliber and multi-center RCTs with large sample sizes should be carried out.

(PROSPERO ID is CRD42023422102)

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来源期刊
European Journal of Integrative Medicine
European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
4.70
自引率
4.00%
发文量
102
审稿时长
33 days
期刊介绍: The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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