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头针治疗帕金森病:一项随机对照试验的系统评价
引用本文:Hun-Soo Lee,Hye-Lim Park,Seung-Jin Lee,Byung-Cheul Shin. 头针治疗帕金森病:一项随机对照试验的系统评价[J]. 中国结合医学杂志, 2013, 19(4): 297-306. DOI: 10.1007/s11655-013-1431-9
作者姓名:Hun-Soo Lee  Hye-Lim Park  Seung-Jin Lee  Byung-Cheul Shin
摘    要:
Objective: To evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson''s disease (PD) patients. Methods: Two independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines. Results: In total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, –3.94; 95% confidence interval (CI), –6.05 to –1.84, P=0.01; I2=0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I2=84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low. Conclusions: The result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.


Scalp Acupuncture for Parkinson's Disease: A Systematic Review of Randomized Controlled Trials
Hun-Soo Lee,Hye-Lim Park,Seung-Jin Lee and Byung-Cheul Shin. Scalp Acupuncture for Parkinson's Disease: A Systematic Review of Randomized Controlled Trials[J]. Chinese journal of integrative medicine, 2013, 19(4): 297-306. DOI: 10.1007/s11655-013-1431-9
Authors:Hun-Soo Lee  Hye-Lim Park  Seung-Jin Lee  Byung-Cheul Shin
Affiliation:11431. School of Korean Medicine, Pusan National University, Yangsan, South Korea
21431. School of Korean Medical Science, Pusan National University, Yangsan, South Korea
31431. Hospital of Korean Medicine, Pusan National University, Yangsan, South Korea
41431. Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
Abstract:

Objective

To evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson’s disease (PD) patients.

Methods

Two independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines.

Results

In total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, ?3.94; 95% confidence interval (CI), ?6.05 to ?1.84, P=0.01; I2 =0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I2 =84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low.

Conclusions

The result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.
Keywords:scalp acupuncture   Parkinson''s disease   randomized controlled trials   systematic review   meta-analysis
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