中药联合多巴胺能药物对帕金森病运动症状及左旋多巴等效剂量影响的Meta分析
Effects of Chinese Medicine Combined with Dopaminergic Drugs and Equivalent Dose of Levodopa on Motor Symptoms in Parkinson's Disease:a Meta-analysis
陈芷妍 1何春颖 2杜毅达 1陈文洁 2詹敏 3韩富华 3李雨桐 1扈潇华 2孙林娟3
作者信息
- 1. 北京中医药大学(北京 100029)
- 2. 中国中医科学院西苑医院(北京 100091);中国中医科学院
- 3. 中国中医科学院西苑医院(北京 100091)
- 折叠
摘要
目的:系统评价中药联用多巴胺能药物对帕金森病(PD)运动症状及左旋多巴等效剂量的影响.方法:对已发表的中药治疗PD的随机临床对照试验(RCT)进行系统评价,通过统一帕金森病评分量表运动症状部分(UPDRS Ⅲ)评分和左旋多巴等效剂量(LED),对中药联用多巴胺能药物改善 PD运动症状及治疗后多巴胺能药物用量变化进行 Meta分析.结果:根据纳入与排除标准筛选文献,最终对 6项RCT进行Meta分析.结果 显示,中药联用多巴胺能药物能显著降低PD病人UPDRSⅢ评分,改善运动症状[MD=-4.03,95%CI(-4.93,-3.12),P<0.000 01];在排除异质性后发现联合中药治疗后能降低 PD病人 LED[MD=-55.35,95%CI(-86.17,-24.52),P=0.000 4].对 4项记录不良反应的 RCT进行分析显示,中药联用多巴胺能药物的不良反应事件发生率较高[MD=2.41,95%CI(1.44,4.02),P=0.000 8].结论:对纳入 6篇文献的 Meta分析结果显示,中药联用多巴胺能药物比单独运用多巴胺能药物能够在改善 PD病人运动症状的同时减少治疗后 LED,其轻度胃肠道症状反应的发生率较高,考虑与口服中药造成的胃肠道刺激相关.
Abstract
Objective:To evaluate the effect of Chinese medicine combined with dopaminergic drugs and equivalent dose of levodopa on motor symptoms in Parkinson's disease(PD).Methods:To conduct a systematic review of published randomized controlled clinical trials(RCT)of traditional Chinese medicine(TCM)in the treatment of PD.The motor symptoms part of Parkinson's Disease Score Scale(UPDRS Ⅲ)and levodopa equivalent dose(LED),a Meta-analysis was conducted on the improvement of motor symptoms of PD with Chinese medicine combined with dopaminergic drugs and the dopaminergic drug.Results:According to inclusion and exclusion criteria,a Meta-analysis of 6 RCTs was performed.The results showed that TCM combined with dopaminergic drugs could significantly reduce UPDRS Ⅲ score and improve motor symptoms in PD patients(MD=-4.03,95%CI-4.93--3.12,P<0.000 01).After excluding heterogeneity,it was found that Chinese medicine treatment could reduce the LED of PD patients(MD=-55.35,95%CI-86.17--24.52,P=0.000 4).Analysis of 4 RCT showed that the incidence of adverse events was higher than that of Chinese medicine combined with dopaminergic drugs(MD=2.41,95%CI 1.44-4.02,P=0.000 8).Conclusion:The results of Meta-analysis showed that the combination of Chinese medicine with dopaminergic drugs could improve the motor symptoms of PD patients and reduce the post-treatment LED,and the incidence of mild gastrointestinal symptoms was more,which was related to gastrointestinal irritation caused by oral Chinese medicine.
关键词
帕金森病/左旋多巴/中药/Meta分析/等效剂量Key words
Parkinson's disease/levodopa/traditional Chinese medicine/Meta-analysis/equivalent dose引用本文复制引用
基金项目
国家自然科学基金面上项目(81873168)
出版年
2024
NETL
NSTL
万方数据