针刺治疗帕金森病运动症状临床研究进展

卢安明 冯玮 袁玉娇 魏嘉琦 林静 王彤 梁军

摘要 帕金森病是第二大神经退行性障碍疾病，随着中国人口老龄化趋势，其患病率逐年增多。目前西医治疗方式并不能满足患者的需要，而中国传统的针刺治疗方法，正在成为帕金森病辅助治疗的重要方式之一。笔者通过中国知网、万方、维普及PubMed等數据库，以“帕金森、颤症、针刺、针灸、电针”等为主题词进行检索，搜集近30年相关文献3 279篇，从中筛选出以针刺为干预手段、帕金森病患者为干预人群，评价指标与运动功能相关RCT 91篇。该综述采用Jadad量表和Cochran偏倚风险评估工具等偏倚风险评估方法及聚类分析等数据挖掘技术系统整理了针刺治疗关于帕金森病运动的RCT研究，同时对其进行质量评价，结局评价指标及用穴规律分析。结果发现，针刺治疗帕金森病运动性症状的临床文献研究质量整体较差，统一帕金森评定量表和改良的Webster量表是最常用的结局评价指标，选用以太冲、风池、合谷、百会等平肝潜阳的穴位为主。本综述为进一步展开高质量多中心的随机对照试验提供坚实的理论基础。

关键词 针刺;帕金森病;随机对照试验;运动性症状;数据挖掘

Research Progress in Clinical Research on Acupuncture Treatment of Motor Symptoms of Parkinson′s Disease

LU Anming1，FENG Wei2，YUAN Yujiao1，WEI Jiaqi1，LIN Jing3，WANG Tong1，LIANG Jun1

（1 First People′s Hospital of Dongcheng District，Beijing 100010，China; 2 South Branch of Guang′anmen Hospital，China

Academy of Chinese Medical，Beijing 102618，China; 3 Yongdingmenwai Community Health Service

Center of Dongcheng District，Beijing 100010，China）

Abstract Parkinson′s disease（PD）is the second largest neurodegenerative disorder，and its prevalence is increasing year by year.At present，Western medical treatment methods do not meet the needs of patients，and traditional Chinese acupuncture treatment methods are becoming auxiliary treatment method.The author searches for the literature with “Parkinson，tremor，acupuncture，electroacupuncture” as the key word through CNKI，Wan Fang，VIP and PubMed.A total of 3，279 related articles for 30 years were retrieved.Acupuncture as an intervention method and patients with Parkinson′s disease as the intervention population were screened out.A total of 91 RCTs related to evaluation indicators and motor function were selected.Moreover，the review uses a bias risk assessment method such as the Jadad scale and the Cochrane bias risk assessment tool and data mining techniques such as cluster analysis systematically analysed its quality evaluation，outcome evaluation index and acupoint use law analysis.The results found that the overall quality of clinical literature research on acupuncture treatment of Parkinson′s disease motor symptoms is poor.The unified Parkinson rating scale and the modified Webster scale are the most commonly used outcome evaluation indicators.TaiChong（LR3），Fengchi（g20），Hegu（L14），Baihui（GV20）and other acupuncture points are mainly used for suppressing hyperactive liver and subsiding yang This review provides a solid theoretical basis for the further development of high-quality multicenter randomized controlled trials.

Keywords Acupuncture; Parkinson′s disease; Randomized controlled trial; Motor symptoms; Data mining

中图分类号：R255.6;R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.02.029

帕金森病（Parkinson Disease，PD）又称震颤麻痹，是一种主要表现为静止性震颤、运动迟缓、肌强直和姿势步态障碍的锥体外系疾病[1]。中老年人本病多发，全人群患病率约为0.3%，65岁以上老年人群患病率为1%～2%[2-3];国内，65岁以上人群中患病为1.7%[4]，而且研究发现本病的发病率与年龄呈正相关，年龄越大，发病率越高。……