Journal of Acupuncture Research

Korean Acupuncture & Moxibustion Medicine Society (대한침구의학회)
권호 표지
DOI QR코드

DOI QR Code

Efficacy of Acupuncture for Parkinson's Disease over the Last Decade: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Yeonju Kim (Department of Neuropsychiatry, College of Korean Medicine, Woosuk University) ;
  • Yigun Lim (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Woosuk University) ;
  • Subin Ahn (Department of Internal Medicine, College of Korean Medicine, Woosuk University) ;
  • Junyeop Oh (College of Korean Medicine, Woosuk University) ;
  • Yoonbyeong Chae (College of Korean Medicine, Woosuk University) ;
  • Yoomin Choi (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Woosuk University) ;
  • Jong Uk Kim (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Woosuk University)
  • Received : 2024.02.02
  • Accepted : 2024.02.13
  • Published : 2024.02.29
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this review is to consolidate findings from clinical investigations spanning the past decade regarding the impact of acupuncture on Parkinson's disease (PD). The objective is to assess the efficacy of acupuncture as a therapeutic approach to PD, with the intention of informing future clinical practices and advancing the foundation for subsequent research endeavors in this area. A comprehensive literature search was conducted to identify clinical trials exploring the effects of acupuncture on PD between January 2014 and August 2023. Databases search included PubMed, EMBASE, CNKI, OASIS, KISS, KMBASE, RISS, and ScienceON. Quantitative evidence from randomized controlled trials (RCTs) was systematically reviewed, and the methodological quality of the included studies was assessed using Cochrane's risk of bias tool. Meta-analysis was performed using Review Manager (RevMan) 5.4.1 software. The systematic review encompassed a total of 38 RCTs involving 2,786 participants. Meta-analysis of 12 studies revealed that individuals treated with a combination of acupuncture and Western medicine exhibited notable improvements compared to those receiving Western medicine alone or sham acupuncture alongside Western medicine. However, the overall quality of the RCTs was deemed low, and no serious adverse events were reported. Across clinical investigations conducted in the past decade, acupuncture appears to hold promise as a complementary treatment for PD patients when administered alongside Western medicine. Nevertheless, this study identifies certain limitations that warrant consideration in future research endeavors. Enhanced emphasis on conducting high-quality RCTs is imperative to comprehensively evaluate the efficacy of acupuncture in managing PD.

Keywords

Acknowledgement

This study received support from Woosuk University.

References

  1. Lee DJ, Shin BC. Current research trend analysis of scalp acupuncture treatment for Parkinson's disease using the search results of China National Knowledge Infrastructure and PubMed. J Korean Med Rehabil 2023;33:95-107. doi: 10.18325/jkmr.2023.33.4.95
  2. Kumar S, Goyal L, Singh S. Tremor and rigidity in patients with Parkinson's disease: emphasis on epidemiology, pathophysiology and contributing factors. CNS Neurol Disord Drug Targets 2022; 21:596-609. doi: 10.2174/1871527320666211006142100
  3. National Health Insurance Service. (NHIS). The number of patients with Parkinson's disease, for which early detection is important, has increased by 15% over the past five years. NHIS [Internet]. Goyang: 2022 Apr 11 [cited 2023 Dec 19]. Available from: https://www.nhis.or.kr/nhis/together/wbhaea01600m01.do?mode=view&articleNo=10816710
  4. Kim SY, Lim YW, Kim E, Park SU. Review on the effect of acupuncture on Parkinson's disease over the last 5 years. J Korean Med 2021;43:112-135. doi: 10.13048/jkm.22010
  5. Kwon SW, Kim TH, Jin C, Jeon JH, Choi TY. Parkinson's disease: clinical practice guideline of Korean medicine. National Institute for Korean Medicine Development; 2021;22.
  6. Kim LH, Jang IS, Kang SY. Acupuncture for Parkinson's disease in China. Korean J Acupunct 2011;28:147-158.
  7. Lee E, Kang K, Kim LH, Kang SY, Sun S, Han C, et al. A review of acupuncture and moxibustion for the treatment of Parkinson's disease. Korean J Orient Intern Med 2014;35:12-23. https://doi.org/10.13048/jkm.14017
  8. Yao X. [Therapeutic observation of acupuncture at acupoints from Yang meridians for Parkinson disease]. Shanghai J Acupunct Moxibustion 2014;33:393-394. Chinese. doi: 10.13460/j.issn.1005-0957.2014.05.0393
  9. Li Y. [Acupuncture combined madopar in the treatment of Parkinson's disease, 120 cases of clinical studies]. China Foreign Med Treat 2015;34:120-121. Chinese. doi: 10.16662/j.cnki.1674-0742.2015.22.073
  10. Lin Y, Liu M. [Thirty-one cases with Parkinson's disease treated with acupuncture combined with medicine]. Henan Tradit Chin Med 2015;35:1430-1432. Chinese. doi: 10.16367/j.issn.1003-5028.2015.06.0599
  11. Shi Y, Zhang H. [Effect of penetrating needling with thick needle at Shenzhu (GV 12) on the unified Parkinson's disease rating scale score]. Shanghai J Acupunct Moxibustion 2015;34:32-33. Chinese. doi: 10.13460/j.issn.1005-0957.2015.09.0827
  12. Jiang H, Gao C, Cao M, Yan Y, Hu Q, Ge L. [Effect of penetrating needling with thick needle at Shenzhu (GV 12) on the unified Parkinson's disease rating scale score]. Shanghai J Acupunct Moxibustion 2016;35:279-281. Chinese. doi: 10.13460/j.issn.1005-0957.2016.03.0279
  13. Li Z. [Observation of acupuncture combined with madopar in the treatment of Parkinson's disease]. Chin J Pract Nerv Dis 2016;19:25-26.
  14. Liu C, Zheng W, Mo H, Zhang X, Huang G. [Effect of Tung's acupuncture on walk and balance function in patients with Parkinson's disease]. Shanghai J Acupunct Moxibustion 2016:35; 1187-1189. Chinese. doi: 10.13460/j.issn.1005-0957.2016.10.1187
  15. Xie J, Wang S, Liang Y. [Clinical study on treatment of Parkinson depression with acupuncture combined with triple viable bacteria]. World Chin Med 2016;11:2116-2119. Chinese. doi: 10.3969/j.issn.1673-7202.2016.10.049
  16. Kluger BM, Rakowski D, Christian M, Cedar D, Wong B, Crawford J, et al. Randomized, controlled trial of acupuncture for fatigue in Parkinson's disease. Mov Disord 2016;31:1027-1032. doi: 10.1002/mds.26597
  17. Li K. [Observation on therapeutic effect of acupuncture combined with medicine on Parkinson disease]. Shanxi J Tradit Chin Med 2017;33:38-39. Chinese. doi: 10.3969/j.issn.1000-7156.2017.09.019
  18. Zhao J. [The random parallel control study of fibrillation three stitches combinating with pramipexole in treatment of Parkinson's disease]. J Pract Tradit Chin Intern Med 2017;31:70-73. Chinese. doi: 10.13729/j.issn.1671-7813.2017.07.26
  19. Aroxa FH, Gondim IT, Santos EL, Coriolano MD, Asano AG, Asano NM. Acupuncture as adjuvant therapy for sleep disorders in Parkinson's disease. J Acupunct Meridian Stud 2017;10:33-38. doi: 10.1016/j.jams.2016.12.007
  20. Lin D, Lai X, Zhuang Z. [Clinical observation on acupuncture of Siguan acupoint for treating wearing-off of Parkinson's disease]. J Zhejiang Chin Med Univ 2018;42:157-159. Chinese. doi: 10.16466/j.issn1005-5509.2018.02.016
  21. Sheng G, Guo Z. [Acupuncture in treating 38 cases of Parkinson's disease]. West J Tradit Chin Med 2018;31:108-110.
  22. Cao L, Li X, Jiang G, Wang Z, Ke Z, Wan J, et al. [Effects of acupuncture combined with cognitive function training on cognitive and motor function in PD patients]. J Clin Acupunct Moxibustion 2018;34:9-12.
  23. Shen L, Wang Q, Shen L, Wang P, Chen X, Gu J, et al. [Therapeutic observation of acupuncture-moxibustion plus Ma Ren capsules for constipation in middle-late stage Parkinson disease]. Shanghai J Acupunct Moxibustion 2018;37:1381-1385. Chinese. doi: 10.13460/j.issn.1005-0957.2018.12.1381
  24. Kong KH, Ng HL, Li W, Ng DW, Tan SI, Tay KY, et al. Acupuncture in the treatment of fatigue in Parkinson's disease: a pilot, randomized, controlled, study. Brain Behav 2017;8:e00897. doi:10.1002/brb3.897
  25. Zhan X, Wang Y. [Therapeutic effect of acupuncture on constipation of Parkinson's disease]. Asia Pac Tradit Med 2019;15: 128-130.
  26. Shen L, Wang Q, Shen L, Wang P, Chen X, Gu J, et al. [Clinical efficacy of acupuncture and moxibustion in treatment of constipation in patients with middle-and advanced-stage Parkinson's disease and effect on medication compliance]. Shanghai J Tradit Chin Med 2019;53:63-66. Chinese. doi: 10.16305/j.1007-1334.2019.03.016
  27. Wang H, Zuo G, Liu J, Jiang Q, Wang S. [Therapeutic observation of acupuncture combined with oral sensorimotor training for dysphagia in Parkinson disease]. Shanghai J Acupunct Moxibustion 2020;39:440-445. Chinese. doi: 10.13460/j.issn.1005-0957.2020.04.0440
  28. You L, Jiang H, Li Q. [Effect of acupuncture on T lymphocyte subsets and SWI in the treatment of PD]. Acta Chin Med Pharmacol 2020;48:35-38. Chinese. doi: 10.19664/j.cnki.1002-2392.200083.
  29. Zhang Y, Liu G, Li Y. [Effect of acupuncture Parkinson's disease accompanied with depression]. Beijing J Tradit Chin Med 2020;39:594-597. Chinese. doi: 10.16025/j.1674-1307.2020.06.019
  30. Luo Z, Bi S, Wang Y. [Study on the therapeutic effects and related mechanisms of acupuncture at Siguan point on Parkinson's disease]. World Chin Med 2020;15:2803-2807.
  31. Kim J, Cho KH, An S, Cui S, Kim SW, Suh J, et al. Effects of acupuncture & Qigong meditation on nonmotor symptoms of Parkinson's disease. J Acupunct Res 2020;37:247-253. doi:10.13045/jar.2020.00066
  32. Jang JH, Park S, An J, Choi JD, Seol IC, Park G, et al. Gait disturbance improvement and cerebral cortex rearrangement by acupuncture in Parkinson's disease: a pilot assessor-blinded, randomized, controlled, parallel-group trial. Neurorehabil Neural Repair 2020;34:1111-1123. doi: 10.1177/1545968320969942
  33. Wu L, Zhang G, Zhou X, Feng Q. [Effects of acupuncture combined with western medication on the levels of NT-3, IGF-1, DA and inflammatory cytokines in patients with Parkinson's disease of liver-kidney yin deficiency pattern]. Shanghai J Acupunct Moxibustion 2021;40:814-819. Chinese. doi:10.13460/j.issn.1005-0957.2021.07.0814
  34. Fan J, Lu W, Wang Y, Yan M, Chen Y, Li Y, et al. [Du three needles combined with hand £¦ foot Luan three needles in the treatment of myotonia during early-mid stage Parkinson's disease: a randomized controlled trial]. J Tradit Chin Med 2022;63: 1662-1667. Chinese. doi:10.13288/j.11-2166/r.2022.17.012.
  35. Zhang J, Han B, Wei R. [Clinical observation of acupuncture in treating Parkinson's disease with yin deficiency of liver and kidney]. J Gannan Med Univ 2022;42:454-457. Chinese. doi:10.3969/j.issn.1001-5779.2022.05.003
  36. Brandin-de la Cruz N, Calvo S, Rodriguez-Blanco C, Herrero P, Bravo-Esteban E. Effects of dry needling on gait and muscle tone in Parkinson's disease: a randomized clinical trial. Acupunct Med 2022;40:3-12. doi: 10.1177/09645284211039232
  37. Fan JQ, Lu WJ, Tan WQ, Liu X, Wang YT, Wang NB, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial. JAMA Netw Open 2022;5:e2232133. doi: 10.1001/jamanetworkopen.2022.32133
  38. Han L, Su X, Zhang Z, Liu Y, Wei Z, Zhang Q, et al. Effect of panlong needling at Jiaji (EX-B 2) on motor dysfunction in patients with Parkinson's disease of liver and kidney deficiency: a randomized controlled trial. Chin Acupunct Moxibustion 2022;42:493-497. doi: 10.13703/j.0255-2930.20210605-0001
  39. Li L, Jin X, Cong W, Du T, Zhang W. Acupuncture in the treatment of Parkinson's disease with sleep disorders and dose response. Biomed Res Int 2022;2022:7403627. doi: 10.1155/2022/7403627. Retraction in: Biomed Res Int 2023;2023:9830671. doi: 10.1155/2023/9830671
  40. Feng WX, Yang ML, Tang LJ, Yan FF, Zhang H. [Effect of acupuncture on swallowing function for patients of Parkinson's disease with dysphagia]. Zhongguo Zhen Jiu 2023;43:739-742. Chinese. doi: 10.13703/j.0255-2930.20220617-0001
  41. Wu C, Li X, Zhu X. [Observation on the efficacy of acupuncture at Siguan points plus Yi Shen Xi Feng decoction for Parkinson disease]. Shanghai J Acupunct Moxib 2023;42:137-141. Chinese. doi: 10.13460/j.issn.1005-0957.2023.02.0137
  42. Luo W. [Clinical observation on acupuncture in the treatment of Parkinson's disease based on meridian tendon theory]. Guangming J Chin Med 2023;38:1932-1935. Chinese. doi: CNKI:SUN: GMZY.0.2023-10-032
  43. Zhao T, Li P. [Impact of acupuncture combined with madopar on swallowing function and nutritional status of patients with Parkinson's disease complicated with dysphagia]. Clin Med Eng 2023;30:769-770. Chinese. doi: CNKI:SUN:YBQJ.0.2023-06-019
  44. Gu J, Shen LR, Shen LP, Wang P, Chen XL, Xu PP, et al. [Clinical study on acupuncture treatment of Parkinson's disease with obsessive state]. Chin Prim Health Care 2023;37:89-91. Chinese. doi: 10.3969/j.issn.1001-568X.2023.02.0022
  45. Li YJ, Leong II, Fan JQ, Yan MY, Liu X, Lu WJ, et al. Efficacy of acupuncture for the treatment of Parkinson's disease-related constipation (PDC): a randomized controlled trial. Front Neurosci 2023;17:1126080. doi: 10.3389/fnins.2023.1126080
  46. Pereira CR, Machado J, Rodrigues J, de Oliveira NM, Criado MB, Greten HJ. Effectiveness of acupuncture in Parkinson's disease symptoms-a systematic review. Healthcare (Basel) 2022;10:2334. doi: 10.3390/healthcare10112334
  47. Im JH, Kang JH, Lee MC. [Treatment of Parkinson's disease]. J Korean Neurol Assoc 2001;19:315-336.
  48. Lee JJ. [Pharmacological treatment in Parkinson's disease]. J Korean Neurol Assoc 2019;37:335-344. Korean. doi: 10.17340/jkna.2019.4.1
  49. Horvath K, Aschermann Z, Acs P, Deli G, Janszky J, Komoly S, et al. Minimal clinically important difference on the Motor Examination part of MDS-UPDRS. Parkinsonism Relat Disord 2015;21:1421-6. doi: 10.1016/j.parkreldis.2015.10.006
  50. Yang DH, Lee KY, Shin HS, Jo SH, Lim CS, Lim JH, et al. [Clinical study of acupuncture theraphy of gastrointestinal side effect of levodopa: focused on idiopathic Pakinson's disease patients]. J Korean Acupunct Moxib Soc 2010;27:11-21.
  51. Kim JY, Kim HJ, Jeon BS. [Prevalence and characteristics of nonmotor symptoms in Korean Parkinson's disease patients and its relationship with experience of alternative therapies]. J Korean Neurol Assoc 2013;31:8-14. Korean.