针灸作为帕金森病睡眠障碍的辅助疗法的疗效：系统回顾和荟萃分析

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-04-26 DOI:10.1016/j.ctim.2024.103044

Wenjing Mi , Miaomiao Meng , Fenghua Xu , Lingzhi Sun

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引用次数: 0

摘要

方法根据系统综述和元分析首选报告项目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA）指南，我们从8个数据库中检索了截至2023年4月30日的论文。实验组采用针灸加常规疗法治疗，对照组仅采用常规疗法或结合假针灸治疗。睡眠质量是主要结果。研究小组按照《科克伦手册》的要求，对文献进行了细致的筛选、数据提取和偏倚风险评估。在可行的情况下，使用Review Manager Version 5.4软件进行荟萃分析。本系统综述共纳入 973 篇文献，其中 15 篇涉及 957 名患者。结果显示，针灸干预措施包括手针、电针、艾灸和放血，每周 1-7 次，每次 2-12 周。与单纯的传统疗法相比，针灸作为一种辅助疗法对睡眠质量和帕金森病的整体症状有更好的疗效。偏倚风险评估显示，盲法和分配隐藏存在缺陷。对所有纳入的研究进行了荟萃分析，结果显示针灸改善了 PDSS 评分（MD =16.57; 95% CI, 7.24-25.90; I2 = 97%）和睡眠障碍的有效率（OR = 5.91; 95% CI, 1.71-20.39; I2 = 54%）；同时，针灸降低了UPDRS评分（MD = -4.29; 95% CI, -6.54 - -2.03; I2 = 77%），提高了PD的有效率（OR = 3.22; 95% CI, 1.81-5.72; I2 = 0%）。结论本研究提供了初步证据，表明针灸作为一种辅助疗法可能与改善帕金森病患者的睡眠障碍有关。由于缺乏高质量的研究，今后应进行更大样本量的假针灸组研究。注册号CRD42022364249（PROSPERO）。

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Efficacy of acupuncture as adjunct therapy for sleep disorders in Parkinson's disease: A systematic review and meta-analysis

Objective

The purpose of this study was to summarize existing clinical studies through a systematic review to explore the efficacy of acupuncture in treating sleep disorders in PD patients.

Methods

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we retrieved the papers through 30 April 2023 from eight databases. The experimental group was treated with acupuncture plus conventional therapy, while the control group was treated with conventional therapy alone or combined with sham acupuncture. The sleep quality was the primary outcome. A team of researchers meticulously performed literature screening, data extraction and risk of bias assessment following the Cochrane Handbook. A meta-analysis was synthesized using Review Manager Version 5.4 software if feasible. The quality of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool.

Results

A total of 973 papers were identified, with 15 papers involving 957 patients were included in this systematic review. The results showed that acupuncture interventions included manual acupuncture, electroacupuncture, moxibustion and bleeding, with 1–7 times every week implemented during 2–12 weeks. Acupuncture as an adjunct therapy compared to conventional therapy alone showed better effect in sleep quality and overall symptoms of PD. Risk of bias assessment showed deficiencies in blinding and allocation concealment. All included studies were synthesized in a meta-analysis, as the result of which, acupuncture improved PDSS scores(MD =16.57; 95% CI, 7.24–25.90; I² = 97%) and effective rate for sleep disorders (OR = 5.91; 95% CI, 1.71–20.39; I² = 54%); meanwhile, acupuncture reduced UPDRS scores(MD = −4.29; 95% CI, −6.54 – −2.03; I² = 77%) and improved effective rate for PD (OR = 3.22; 95% CI, 1.81–5.72; I² = 0%). The quality of evidence ranged from low to moderate by GRADE.

Conclusion

This study provides initial evidence that acupuncture as an adjunct therapy might be associated with improvement of sleep disorders in PD. Due to the lack of high-quality studies, larger sample size studies with sham acupuncture groups should be conducted in future.