Acupuncture and moxibustion for Parkinson’s disease: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

ZHONG Wanqi , YIN Zihan , LI Yaqin , BAO Qiongnan , ZHANG Xinyue , XIA Manze , WU Kexin , YAO Jin ,  LIANG Fanrong

School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;

Corresponding?author：

LIANG Fanrong, Email: acuresearch@126.com

Keywords：

Acupuncture and moxibustion; Parkinson’s disease; Overview of systematic reviews

DOI：

10.7507/1672-2531.202303190

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize and evaluate the quality of methodology, report and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture and moxibustion interventions for Parkinson's disease. Methods Eight databases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were searched from inception to May 1, 2023. The quality of methodology, report and evidence involved in these studies were evaluated by AMSTAR 2, PRISMA and GRADE tool. Results A total of 28 SRs/MAs were included, and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease. The methodological quality of all studies was extremely low. Thirteen reports were relatively complete, 14 reports had certain flaws, and 1 report had relatively serious flaws. And of the 126 reports for seven outcomes, 1 was graded as high, 12 as moderate, 57 as low, and 56 as critically low. Conclusion The current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease, but the methodological quality and evidence quality of related SRs/MAs are low, and the standardization still needs to be improved. The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.

Citation： ZHONG Wanqi, YIN Zihan, LI Yaqin, BAO Qiongnan, ZHANG Xinyue, XIA Manze, WU Kexin, YAO Jin, LIANG Fanrong. Acupuncture and moxibustion for Parkinson’s disease: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2023, 23(8): 936-944. doi: 10.7507/1672-2531.202303190 Copy

1.	陳芝君, 馬建, 唐娜, 等. 中國帕金森病疾病負擔變化趨勢分析及預測. 中國慢性病預防與控制, 2022, 30(9): 649-654.
2.	劉濤, 王遙, 白倩, 等. 帕金森病患者的疾病經濟負擔現狀及影響因素研究. 臨床神經病學雜志, 2022, 35(3): 166-170.
3.	李雪, 姜迪, 陳金榆, 等. 基于供方視角的我國帕金森病患者直接醫療成本測算. 衛生經濟研究, 2021, 38(1): 26-28.
4.	賈建平, 陳生弟. 神經病學(第8版). 北京: 人民衛生出版社, 2018: 328-329.
5.	Bega D, Gonzalez-Latapi P, Zadikoff C, et al. A review of the clinical evidence for complementary and alternative therapies in Parkinson's disease. Curr Treat Options Neurol, 2014, 16(10): 314.
6.	李艷榮, 樊慧杰, 孫芮芮, 等. 帕金森病的中醫藥治療研究進展. 山西中醫藥大學學報, 2022, 23(4): 381-385+392.
7.	Hansen CA, Miller DR, Annarumma S, et al. Levodopa-induced dyskinesia: a historical review of Parkinson's disease, dopamine, and modern advancements in research and treatment. J Neurol, 2022, 269(6): 2892-2909.
8.	Li K, Xu S, Wang R, et al. Electroacupuncture for motor dysfunction and constipation in patients with Parkinson's disease: a randomised controlled multi-centre trial. EClinicalMedicine, 2023, 56: 101814.
9.	Fan JQ, Lu WJ, Tan WQ, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial. JAMA Netw Open, 2022, 5(9): e2232133.
10.	Pereira CR, Machado J, Rodrigues J, et al. Effectiveness of acupuncture in Parkinson's disease symptoms-a systematic review. Healthcare (Basel), 2022, 10(11): 2334.
11.	中華醫學會神經病學分會帕金森病及運動障礙學組, 中國醫師協會神經內科醫師分會帕金森病及運動障礙專業. 中國帕金森病的診斷標準(2016版). 中華神經科雜志, 2016, 49(4): 268-271.
12.	Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson's disease. Neurology, 2001, 57(8): 1497-1499.
13.	陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具AMSTAR2解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
14.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339: b2535.
15.	Balshem H, Helfanda M, J. Schunemann H, 等. GRADE指南:Ⅲ. 證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
16.	楊麗紅, 杜元灝, 熊俊, 等. 針灸治療帕金森病療效的系統評價. 中國循證醫學雜志, 2010, 10(6): 711-717.
17.	孫妙璇, 張雄. 針灸治療帕金森病非運動癥狀療效的Meta分析. 上海中醫藥大學學報, 2013, 27(5): 41-48,69.
18.	郭敏. 針刺治療帕金森病的系統評價和meta分析. 杭州: 浙江中醫藥大學, 2016.
19.	眭蘭, 宋芬芬, 蔡艷. 普通針刺聯合美多芭治療帕金森病的系統評價及meta分析. 湖南中醫藥大學學報, 2016, 36(2): 1384-1386.
20.	尹洪娜, 韓超, 孫忠人, 等. 針刺治療帕金森病的系統評價和meta分析. 針灸臨床雜志, 2016, 32(8): 67-70.
21.	張雪淳, 蔣麗, 伍亞男, 等. 基于Meta分析的艾灸治療帕金森病療效研究. 亞太傳統醫藥, 2016, 12(14): 96-100.
22.	歐陽莎, 許巍. 針灸與西藥治療帕金森病療效比較的系統評價. 中醫藥通報, 2017, 16(1): 34-38.
23.	劉艷慧, 陳濤, 鄧益東, 等. 針刺治療帕金森病臨床療效的Meta分析. 中國醫師雜志, 2018, 20(1): 16-23, 27.
24.	柳默涵, 王述菊, 馬駿, 等. 頭針治療帕金森病的Meta分析. 時珍國醫國藥, 2019, 30(8): 2011-2014.
25.	李旻穎. 基于“從陽論治”針灸治療帕金森病肌強直的臨床研究與機制探索. 廣州: 廣州中醫藥大學, 2020.
26.	李曉艷, 董勤建, 馬天陽, 等. 針刺治療帕金森病隨機對照試驗的系統評價. 黑龍江中醫藥, 2020, 49(3): 398-399.
27.	周景, 李俊龍, 李建良, 等. 針刺治療帕金森病原發性運動癥狀的Meta分析. 環球中醫藥, 2020, 13(2): 326-333.
28.	鄭夢文. 針灸治療帕金森病的系統評價與Meta分析. 廣州: 暨南大學, 2019.
29.	王延慶. 針灸療法治療帕金森病的網狀meta分析. 烏魯木齊: 新疆醫科大學, 2020.
30.	傅嘉, 時晶. 針灸治療改善帕金森病患者睡眠情況的Meta分析. 新疆醫科大學學報, 2022, 45(11): 1348-1354, 1361.
31.	孫英, 潘佳慧, 張方圓, 等. 針灸治療帕金森病非運動癥狀的Meta分析. 廣州中醫藥大學學報, 2023, 40(2): 516-525.
32.	Cho KH, Kim TH, Kwon S, et al. Moxibustion for idiopathic Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med, 2017, 13: 26-33.
33.	Ko JH, Lee H, Kim SN, et al. Does acupuncture protect dopamine neurons in Parkinson's disease rodent model?: a systematic review and meta-analysis. Front Aging Neurosci, 2019, 11(5): 102.
34.	Lee HS, Park HL, Lee SJ, et al. Scalp acupuncture for Parkinson's disease: a systematic review of randomized controlled trials. Chin J Integr Med, 2013, 19(4): 297-306.
35.	Lee MS, Shin BC, Kong JC, et al. Effectiveness of acupuncture for Parkinson's disease: a systematic review. Mov Disord, 2008, 23(11): 1505-1515.
36.	Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore), 2017, 96(3): e5836.
37.	Li Q, Wu C, Wang X, et al. Effect of acupuncture for non-motor symptoms in patients with Parkinson's disease: a systematic review and meta-analysis. Front Aging Neurosci, 2022, 14: 995850.
38.	Liu H, Chen L, Zhang Z, et al. Effectiveness and safety of acupuncture combined with madopar for Parkinson's disease: a systematic review with meta-analysis. Acupunct Med, 2017, 35(6): 404-412.
39.	Qiang T, Sun H, Gai C, et al, Combination therapy of scalp electro-acupuncture and medication for the treatment of Parkinson's disease: a systematic review and meta-analysis. J Tradit Chin Med Sci, 2019, 6(1): 26-34.
40.	Wei Y, Yao QP, Zhang PF, et al, Efficacy and safety of acupuncture in the treatment of Parkinson's: a meta analysis. Acta Medica Mediterranea, 2022, 38: 2003.
41.	Wen X, Li K, Wen H, et al. Acupuncture-related therapies for Parkinson's disease: a meta-analysis and qualitative review. Front Aging Neurosci, 2021, 13: 676827.
42.	Kwon M, Cheong MJ, Leem J, et al. Effect of acupuncture on movement function in patients with Parkinson's disease: network meta-analysis of randomized controlled trials. Healthcare (Basel), 2021, 9(11): 1502.
43.	Noh H, Kwon S, Cho SY, et al. Effectiveness and safety of acupuncture in the treatment of Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med, 2017, 34: 86-103.
44.	Sun Y, Sheng J, Liu T, et al. Combination treatment of acupoint therapy and conventional medication for motor function of Parkinson's disease: a systematic review and meta-analysis. Complement Ther Clin Pract, 2023, 50: 101677.
45.	Ruppar T. Meta-analysis: how to quantify and explain heterogeneity. Eur J Cardiovasc Nurs, 2020, 19(7): 646-652.
46.	張卓文, 翁曉蘭. "雙一流"背景下期刊論文規范"四要素"結構式摘要的實踐優勢. 浙江中醫藥大學學報, 2022, 46(11): 1292-1294,1300.
47.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.

1. 陳芝君, 馬建, 唐娜, 等. 中國帕金森病疾病負擔變化趨勢分析及預測. 中國慢性病預防與控制, 2022, 30(9): 649-654.
2. 劉濤, 王遙, 白倩, 等. 帕金森病患者的疾病經濟負擔現狀及影響因素研究. 臨床神經病學雜志, 2022, 35(3): 166-170.
3. 李雪, 姜迪, 陳金榆, 等. 基于供方視角的我國帕金森病患者直接醫療成本測算. 衛生經濟研究, 2021, 38(1): 26-28.
4. 賈建平, 陳生弟. 神經病學(第8版). 北京: 人民衛生出版社, 2018: 328-329.
5. Bega D, Gonzalez-Latapi P, Zadikoff C, et al. A review of the clinical evidence for complementary and alternative therapies in Parkinson's disease. Curr Treat Options Neurol, 2014, 16(10): 314.
6. 李艷榮, 樊慧杰, 孫芮芮, 等. 帕金森病的中醫藥治療研究進展. 山西中醫藥大學學報, 2022, 23(4): 381-385+392.
7. Hansen CA, Miller DR, Annarumma S, et al. Levodopa-induced dyskinesia: a historical review of Parkinson's disease, dopamine, and modern advancements in research and treatment. J Neurol, 2022, 269(6): 2892-2909.
8. Li K, Xu S, Wang R, et al. Electroacupuncture for motor dysfunction and constipation in patients with Parkinson's disease: a randomised controlled multi-centre trial. EClinicalMedicine, 2023, 56: 101814.
9. Fan JQ, Lu WJ, Tan WQ, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial. JAMA Netw Open, 2022, 5(9): e2232133.
10. Pereira CR, Machado J, Rodrigues J, et al. Effectiveness of acupuncture in Parkinson's disease symptoms-a systematic review. Healthcare (Basel), 2022, 10(11): 2334.
11. 中華醫學會神經病學分會帕金森病及運動障礙學組, 中國醫師協會神經內科醫師分會帕金森病及運動障礙專業. 中國帕金森病的診斷標準(2016版). 中華神經科雜志, 2016, 49(4): 268-271.
12. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson's disease. Neurology, 2001, 57(8): 1497-1499.
13. 陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具AMSTAR2解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
14. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339: b2535.
15. Balshem H, Helfanda M, J. Schunemann H, 等. GRADE指南:Ⅲ. 證據質量分級. 中國循證醫學雜志, 2011, 11(4): 451-455.
16. 楊麗紅, 杜元灝, 熊俊, 等. 針灸治療帕金森病療效的系統評價. 中國循證醫學雜志, 2010, 10(6): 711-717.
17. 孫妙璇, 張雄. 針灸治療帕金森病非運動癥狀療效的Meta分析. 上海中醫藥大學學報, 2013, 27(5): 41-48,69.
18. 郭敏. 針刺治療帕金森病的系統評價和meta分析. 杭州: 浙江中醫藥大學, 2016.
19. 眭蘭, 宋芬芬, 蔡艷. 普通針刺聯合美多芭治療帕金森病的系統評價及meta分析. 湖南中醫藥大學學報, 2016, 36(2): 1384-1386.
20. 尹洪娜, 韓超, 孫忠人, 等. 針刺治療帕金森病的系統評價和meta分析. 針灸臨床雜志, 2016, 32(8): 67-70.
21. 張雪淳, 蔣麗, 伍亞男, 等. 基于Meta分析的艾灸治療帕金森病療效研究. 亞太傳統醫藥, 2016, 12(14): 96-100.
22. 歐陽莎, 許巍. 針灸與西藥治療帕金森病療效比較的系統評價. 中醫藥通報, 2017, 16(1): 34-38.
23. 劉艷慧, 陳濤, 鄧益東, 等. 針刺治療帕金森病臨床療效的Meta分析. 中國醫師雜志, 2018, 20(1): 16-23, 27.
24. 柳默涵, 王述菊, 馬駿, 等. 頭針治療帕金森病的Meta分析. 時珍國醫國藥, 2019, 30(8): 2011-2014.
25. 李旻穎. 基于“從陽論治”針灸治療帕金森病肌強直的臨床研究與機制探索. 廣州: 廣州中醫藥大學, 2020.
26. 李曉艷, 董勤建, 馬天陽, 等. 針刺治療帕金森病隨機對照試驗的系統評價. 黑龍江中醫藥, 2020, 49(3): 398-399.
27. 周景, 李俊龍, 李建良, 等. 針刺治療帕金森病原發性運動癥狀的Meta分析. 環球中醫藥, 2020, 13(2): 326-333.
28. 鄭夢文. 針灸治療帕金森病的系統評價與Meta分析. 廣州: 暨南大學, 2019.
29. 王延慶. 針灸療法治療帕金森病的網狀meta分析. 烏魯木齊: 新疆醫科大學, 2020.
30. 傅嘉, 時晶. 針灸治療改善帕金森病患者睡眠情況的Meta分析. 新疆醫科大學學報, 2022, 45(11): 1348-1354, 1361.
31. 孫英, 潘佳慧, 張方圓, 等. 針灸治療帕金森病非運動癥狀的Meta分析. 廣州中醫藥大學學報, 2023, 40(2): 516-525.
32. Cho KH, Kim TH, Kwon S, et al. Moxibustion for idiopathic Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med, 2017, 13: 26-33.
33. Ko JH, Lee H, Kim SN, et al. Does acupuncture protect dopamine neurons in Parkinson's disease rodent model?: a systematic review and meta-analysis. Front Aging Neurosci, 2019, 11(5): 102.
34. Lee HS, Park HL, Lee SJ, et al. Scalp acupuncture for Parkinson's disease: a systematic review of randomized controlled trials. Chin J Integr Med, 2013, 19(4): 297-306.
35. Lee MS, Shin BC, Kong JC, et al. Effectiveness of acupuncture for Parkinson's disease: a systematic review. Mov Disord, 2008, 23(11): 1505-1515.
36. Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore), 2017, 96(3): e5836.
37. Li Q, Wu C, Wang X, et al. Effect of acupuncture for non-motor symptoms in patients with Parkinson's disease: a systematic review and meta-analysis. Front Aging Neurosci, 2022, 14: 995850.
38. Liu H, Chen L, Zhang Z, et al. Effectiveness and safety of acupuncture combined with madopar for Parkinson's disease: a systematic review with meta-analysis. Acupunct Med, 2017, 35(6): 404-412.
39. Qiang T, Sun H, Gai C, et al, Combination therapy of scalp electro-acupuncture and medication for the treatment of Parkinson's disease: a systematic review and meta-analysis. J Tradit Chin Med Sci, 2019, 6(1): 26-34.
40. Wei Y, Yao QP, Zhang PF, et al, Efficacy and safety of acupuncture in the treatment of Parkinson's: a meta analysis. Acta Medica Mediterranea, 2022, 38: 2003.
41. Wen X, Li K, Wen H, et al. Acupuncture-related therapies for Parkinson's disease: a meta-analysis and qualitative review. Front Aging Neurosci, 2021, 13: 676827.
42. Kwon M, Cheong MJ, Leem J, et al. Effect of acupuncture on movement function in patients with Parkinson's disease: network meta-analysis of randomized controlled trials. Healthcare (Basel), 2021, 9(11): 1502.
43. Noh H, Kwon S, Cho SY, et al. Effectiveness and safety of acupuncture in the treatment of Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med, 2017, 34: 86-103.
44. Sun Y, Sheng J, Liu T, et al. Combination treatment of acupoint therapy and conventional medication for motor function of Parkinson's disease: a systematic review and meta-analysis. Complement Ther Clin Pract, 2023, 50: 101677.
45. Ruppar T. Meta-analysis: how to quantify and explain heterogeneity. Eur J Cardiovasc Nurs, 2020, 19(7): 646-652.
46. 張卓文, 翁曉蘭. "雙一流"背景下期刊論文規范"四要素"結構式摘要的實踐優勢. 浙江中醫藥大學學報, 2022, 46(11): 1292-1294,1300.
47. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.

Chinese Journal of Evidence-Based Medicine

Acupuncture and moxibustion for Parkinson’s disease: an overview of systematic reviews

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