Objective To evaluate the effectiveness and safety of acupuncture combined with Madopar for the treatment of Parkinson’s disease (PD), compared to the use of Madopar alone.
Methods A systematic search was carried out for randomised controlled trials (RCTs) of acupuncture and Madopar for the treatment of PD published between April 1995 and April 2015. The primary outcome was total effectiveness rate and secondary outcomes included Unified Parkinson’s Disease Rating Scale (UPDRS) scores. Data were pooled and analysed with RevMan 5.3. Results were expressed as relative ratio (RR) with 95% confidence interval (CIs).
Results Finally, 11 RCTs with 831 subjects were included. Meta-analyses showed that acupuncture combined with Madopar for the treatment of PD can significantly improve the clinical effectiveness compared with Madopar alone (RR=1.28, 95% CI 1.18 to 1.38, P<0.001). It was also found that acupuncture combined with Madopar significantly improved the UPDRS II (SMD=−1.00, 95% CI −1.71 to –0.29, P=0.006) and UPDRS I–IV total summed scores (SMD=−1.15, 95% CI −1.63 to –0.67, P<0.001) but not UPDRS I (SMD=−0.37, 95% CI −0.77 to 0.02, P=0.06), UPDRS III (SMD=−0.93, 95% CI −2.28 to 0.41, P=0.17) or UPDRS IV (SMD=−0.78, 95% CI −2.24 to 0.68, P=0.30) scores. Accordingly, acupuncture combined with Madopar appeared to have a positive effect on activities of daily life and the general condition of patients with PD, but was not better than Madopar alone for the treatment of mental activity, behaviour, mood and motor disability. In the safety evaluation, it was found that acupuncture combined with Madopar was associated with significantly fewer adverse effects including gastrointestinal reactions (RR=0.38, 95% CI 0.23 to 0.65, P<0.001), on–off phenomena (RR=0.27, 95% CI 0.11 to 0.66, P=0.004) and mental disorders (RR=0.24, 95% CI 0.06 to 0.92, P=0.04) but did not significantly reduce dyskinesia (RR=0.64, 95% CI 0.35 to 1.16, P=0.14).
Conclusion Acupuncture combined with Madopar appears, to some extent, to improve clinical effectiveness and safety in the treatment of PD, compared with Madopar alone. This conclusion must be considered cautiously, given the quality of most of the studies included was low. Therefore, more high-quality, multicentre, prospective, RCTs with large sample sizes are needed to further clarify the effect of acupuncture combined with Madopar for PD.
- parkinson’s disease
- systematic reviews
- complementary medicine
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fn HL and LinC are joint first authors and contributed equally to this work.
Contributors SZ and LiaC performed the database searching and screening. GG, WC and HD extracted the data and evaluated the quality of all eligible studies and risk of bias. LinC and HL conducted the meta-analysis and interpreted the data. HL, ZZ and TL checked the data and revised the paper. All authors approved the final version of the manuscript accepted for publication.
Funding Traditional Chinese Medicine Bureau of Guangdong Province (research project no. 20161064).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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