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Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review
Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD). Methods: A literature search within eight databases [...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282198/ https://www.ncbi.nlm.nih.gov/pubmed/34276340 http://dx.doi.org/10.3389/fnagi.2021.676827 |
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author | Wen, Xiaopeng Li, Kunbin Wen, Hao Wang, Qian Wu, Zhiyuan Yao, Xianli Jiao, Bing Sun, Pingge Ge, Shuqi Wen, Chenyang Lu, Liming |
author_facet | Wen, Xiaopeng Li, Kunbin Wen, Hao Wang, Qian Wu, Zhiyuan Yao, Xianli Jiao, Bing Sun, Pingge Ge, Shuqi Wen, Chenyang Lu, Liming |
author_sort | Wen, Xiaopeng |
collection | PubMed |
description | Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD). Methods: A literature search within eight databases [including Medline, Embase, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database] was performed covering a time frame from their inception to August 2020. Randomized controlled trials (RCTs) comparing acupuncture-related therapies combined with conventional medication vs. conventional medication in patients with PD were eligible. Two authors independently assessed the risk of bias. Assessments were performed with the total and subscales scores of the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), the dosage of Madopar, Mini-Mental State Examination (MMSE), and 17-item Hamilton Depression Scale (HAMD). Data were analyzed by adopting the Cochrane Collaboration's RevMan 5.4 (Review Man, Copenhagen, Denmark); and mean effect sizes and 95% confidence intervals were estimated. Tests for heterogeneity were used to assess differences in treatment effects across different types of acupuncture used. Results: Sixty-six trials met the inclusion criteria, of which 61 trials provided data for the meta-analysis. We defined high-quality articles as those with a low risk of bias in four or more domains; and only 10 (15.15%) articles were of high quality. Compared with the controls, acupuncture-related therapies with conventional medication achieved a benefit in the primary outcomes of UPDRS (motor subscore: −3.90, −4.33 to −3.49, P < 0.01; total score: −7.37 points, −8.91 to −5.82, P < 0.001; activities of daily living subscore: −3.96, −4.96 to −2.95, P < 0.01). For the subgroup difference test among the effects of different acupuncture methods, significant differences existed in outcomes with the UPDRS-III, UPDRS-I, UPDRS-IV, and PDQ-39 scores and Madopar dosage, while non-significant differences existed with the UPDRS-total, UPDRS-II, HAMD, and MMSE scores. Conclusions: Acupuncture-related therapies combined with conventional medication may benefit individuals with PD. Our review findings should be considered with caution because of the methodological weaknesses in the included trials. Future, large randomized trials of acupuncture-related therapies for PD with high methodological quality are warranted. Systematic Review Registration: Identifier CRD42021228110. |
format | Online Article Text |
id | pubmed-8282198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82821982021-07-16 Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review Wen, Xiaopeng Li, Kunbin Wen, Hao Wang, Qian Wu, Zhiyuan Yao, Xianli Jiao, Bing Sun, Pingge Ge, Shuqi Wen, Chenyang Lu, Liming Front Aging Neurosci Neuroscience Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD). Methods: A literature search within eight databases [including Medline, Embase, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database] was performed covering a time frame from their inception to August 2020. Randomized controlled trials (RCTs) comparing acupuncture-related therapies combined with conventional medication vs. conventional medication in patients with PD were eligible. Two authors independently assessed the risk of bias. Assessments were performed with the total and subscales scores of the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), the dosage of Madopar, Mini-Mental State Examination (MMSE), and 17-item Hamilton Depression Scale (HAMD). Data were analyzed by adopting the Cochrane Collaboration's RevMan 5.4 (Review Man, Copenhagen, Denmark); and mean effect sizes and 95% confidence intervals were estimated. Tests for heterogeneity were used to assess differences in treatment effects across different types of acupuncture used. Results: Sixty-six trials met the inclusion criteria, of which 61 trials provided data for the meta-analysis. We defined high-quality articles as those with a low risk of bias in four or more domains; and only 10 (15.15%) articles were of high quality. Compared with the controls, acupuncture-related therapies with conventional medication achieved a benefit in the primary outcomes of UPDRS (motor subscore: −3.90, −4.33 to −3.49, P < 0.01; total score: −7.37 points, −8.91 to −5.82, P < 0.001; activities of daily living subscore: −3.96, −4.96 to −2.95, P < 0.01). For the subgroup difference test among the effects of different acupuncture methods, significant differences existed in outcomes with the UPDRS-III, UPDRS-I, UPDRS-IV, and PDQ-39 scores and Madopar dosage, while non-significant differences existed with the UPDRS-total, UPDRS-II, HAMD, and MMSE scores. Conclusions: Acupuncture-related therapies combined with conventional medication may benefit individuals with PD. Our review findings should be considered with caution because of the methodological weaknesses in the included trials. Future, large randomized trials of acupuncture-related therapies for PD with high methodological quality are warranted. Systematic Review Registration: Identifier CRD42021228110. Frontiers Media S.A. 2021-07-01 /pmc/articles/PMC8282198/ /pubmed/34276340 http://dx.doi.org/10.3389/fnagi.2021.676827 Text en Copyright © 2021 Wen, Li, Wen, Wang, Wu, Yao, Jiao, Sun, Ge, Wen and Lu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Wen, Xiaopeng Li, Kunbin Wen, Hao Wang, Qian Wu, Zhiyuan Yao, Xianli Jiao, Bing Sun, Pingge Ge, Shuqi Wen, Chenyang Lu, Liming Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title | Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title_full | Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title_fullStr | Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title_full_unstemmed | Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title_short | Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review |
title_sort | acupuncture-related therapies for parkinson's disease: a meta-analysis and qualitative review |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282198/ https://www.ncbi.nlm.nih.gov/pubmed/34276340 http://dx.doi.org/10.3389/fnagi.2021.676827 |
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