Combination treatment of acupoint therapy and conventional medication for motor function of Parkinson's disease: A systematic review and meta-analysis

Combination treatment with acupoint therapy and conventional medication (CM) has been proposed as a strategy that could improve motor dysfunction in Parkinson's disease (PD). We performed this systematic review and meta-analysis to assess the effects of this combination treatment on motor function in patients with PD. We searched randomized controlled trials (RCTs) from eight databases, comparing combined acupoint therapy and CM and CM (alone or with sham interventions). The quality of the trials was evaluated according to the Cochrane risk of bias. Subgroup and sensitivity analyses were performed on different types of acupoint interventions. Forty-seven trials of 2929 participants were included, with 45 studies used for the meta-analyses. Combination treatment yielded an improved reduction in United Parkinson's disease rating scale (UPDRS) III of −3.85 [95% CI, −4.83 to −2.86] and Webster scale score of −3.17 [95% CI, −4.07 to −2.27]. Further analyses demonstrated that real (compared with sham) intervention was linked to a decreased UPDRS III of −2.02 ([95% CI, −3.60 to −0.44], I2 = 40%), and beneficial effects were observed when combination intervention was used for patients with Hoehn−Yahr (H–Y) stages >3 with mild to moderate stimulation for 4−12-week treatment. Acupoint therapy and CM treatment may improve motor function of patients with PD. Patients with H–Y stage >3 could tolerate real acupoint intervention with mild to moderate stimulation for 4−12-week treatment and showed improvement. However, this was demonstrated with low to moderate levels of evidence in statistical description.