Meta-analysis Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Depression In Parkinson’s Disease

Objective:Toconducta Mta-analysisontheclinicalefficacyandsafetyofe TCMassistedwesternmedicineinthetreatmentofpatientswithdepressionin Parkinson’sdisease.Methods:Chinesedatabaseand Eglishdatabaseweresearched.The Cinesen h databasesinclude CKI,Wanfang Dta,VIP,and CM.And Eglishdatabasesinclude N a B n Pubmed,Webof Siencedatabase,the Cchrane Lbrary.Theretrievaltimeisfromc o i theestablishmentofthedatabaseto Fbruary2021.Then,thebasicinformatione wasextracted,andthequalityoftheincludedstudieswasevaluatedbyusingthe modified Jdadscaleandthe Cchranebiastool.Meta-analysisoftheincludeddataa o wasperformedusing Rv Mn5.4software.e aResults:Atotalof28literatureswereincludedinthisstudy,allofwhich wererandomizedcontrolledtrials.Thetotalsamplesizewas2095 cases,including1046casesinthecontrolgroupand1049casesintheexperimentalgroup.The data ofeachliteratureof HMD,UPDRS,HAMA,ADL,efficiencyandotherscoringscale A wereusedforintegrationanalysisbyusing Rv Mn5.4software.Heterogeneitye a testwasconductedfirst.Subgroupanalysiswasperformedifthelevelofheterogeneity testwashighandalargenumberofliteratureswereincluded.Sensitivityanalysis wasconductedonalldataandthenforestmapsweremade.Ifmorethantenliteratures wereincluded,funnelplotanalysiswasperformed.Specific Mta-analysisresultsaree asfollows.(1)Effectiverate:effectiverateof UDRSscale:P RR=1.22(95%CI)[0.86,1.72],P=0.27>0.05,therewasnostatisticaldifferenceintheeffective rateof UDRSbetweenthetwogroups.Anditisnotcertainthattheeffectiverate P of UDRSscaleforthetreatmentof Prkinson’sdepressionwithintegratedtraditional P a Chineseandwesternmedicineisbetterthanthecontrolgroup’s.Thescaleof HMDA efficiency:RR=1.27(95%CI)[1.17,1.38],P<0.00001<0.05,thecomparisonof effectiverateof HMDscalebetweenthetwogroupswasstatisticallysignificant.A theeffectiverateof HMDscaleforthetreatmentof Prkinson’sdepressionwith A a integratedtraditional Cineseandwesternmedicineisbetterthanthecontrolh group’s.Effectivenessof TMsyndromescale:Suggestions:RR=1.41(95%CI)C[1.22,1.64],P<0.00001<0.05,thecomparisonofeffectivenessof TMsyndrome C scalebetweenthetwogroupswasstatisticallysignificant.the Efectivenessof TMf C syndromescaleforthetreatmentof Prkinson’sdepressionwithintegratedtraditionala Chineseandwesternmedicineisbetterthanthecontrolgroup’s.(2)UPDRSscale:UPDRSscorescale:SMD= 1.05(95% CI)[1.39,0.72],P<0.00001<0.05,Tip:thecomparisonofthe UDRStotalscorescalebetween P thetwogroupswasstatisticallysignificant.The UDRStotalscorescaleof TMP C assistedwithwesternmedicineinimprovingtreatmentwasbetterthanthecontrol group’s.UPDRS-I scale: MD=-1.39(95%CI)[-1.92,-0.86],P<0.00001<0.05,thecomparisonof UDRS-IP scalebetweenthetwogroupswasstatisticallysignificant.Andthe UDRS-Iscale P of TMassisted C withwesternmedicineinimprovingtreatmentwasbetterthanthe control group’s.UPDRS-I scale:MD=-2.39(95%CI)[-4.05,-0.72],P=0.005<0.05,thecomparisonof UPDRS-Iscalebetweenthetwogroupswasstatisticallysignificant.The UDRS-IP scaleof TMassistedwithwesternmedicineinimprovingtreatmentwasbetterthan C the control group’s.UPDRS-III scale:MD=-3.09(95%CI)[-4.53,-1.65],P<0.0001<0.05,thecomparisonof UPDRS-IIscalebetweenthetwogroupswasstatisticallysignificant.The UDRS-IP I scaleof TMassistedwithwesternmedicineinimprovingtreatmentwassuperior C to the control group’s.UPDRS-IV scale:MD=-0.82(95%CI)[-1.28,-0.35],P=0.0006<0.05.the comparison of UPDRS-IVscalebetweenthetwogroupswasstatisticallysignificant,andthe UPDRS-IVscaleof TMassistedwithwesternmedicineinimprovingtreatmentwas C superiortothecontrolgroup’s.(3)HAMDscale:SMD=-1.45(95%CI)[-1.80,-1.11],P<0.00001<0.05,thecomparisonof HMDscalebetweenthetwogroupswasstatisticallysignificant,A andthe HMDscaleof TMassistedwithwesternmedicineinimprovingtreatment A C wasbetterthanthecontrolgroup’s.(4)HAMAscale:SMD=-2.08(95%CI)[-2.79,-1.39],P<0.00001<0.05,thecomparisonof HMAscalebetweenthetwogroupswasstatisticallysignificant,A andthe HMAscaleofof TMassistedwithwesternmedicineinimprovingtreatment A C wasbetterthanthecontrolgroup’s.(5)PDQ-39 scale:MD=-7.48(95%CI)[-9.54,-5.42],P<0.00001<0.05.Thecomparisonof PQ-39 scalebetweenthetwogroupswas D statisticallysignificant.the PQ-39 scaleof TMassistedwithwesternmedicine D C inimprovingtreatmentwasbetterthanthecontrolgroup’s.(6)SDSscale:MD=-6.78(95%CI)[-13.03,-0.54],P=0.03<0.05,the comparisonof SSscalebetweenthetwogroupswasstatisticallysignificant,and D the SSscaleofimproving D depression in Prkinson’diseasewith Cinesemedicinea h assistedbywesternmedicinewasbetterthanthecontrolgroup’s.(7)TCM syndrome score scale: SMD=-1.21(95%CI)[-1.94,-0.48],P=0.001<0.05,thecomparisonof TMsyndromescorescalebetweenthetwogroups C wasstatisticallysignificant,and TMsyndromescorescaleof TMassistedwith C C westernmedicineinimprovingdepression in Prkinson’diseasewasbetterthanthea controlgroup’s.(8)ADLscale:MD=-4.71(95%CI)[-7.18,-2.23],P=0.0002<0.05,thecomparisonof ALscalebetweenthetwogroupswasstatisticallysignificant,D andthe ALscaleof TMassistedwithwesternmedicineinimprovingdepression D C in Prkinson’diseasewasbetterthanthecontrolgroup’s.a(9)TESS scale:MD=-1.22(95%CI)[-1.55,-0.88],P=0.0001<0.05,thecomparisonof TSSscalebetween E thetwogroupswasstatisticallysignificant,Andthe TSSscaleof TMassisted E C westernmedicineinimprovingdepressionin Prkinson’diseaseof TSSscalewasa E betterthanthecontrolgroup’s.(10)Adverse reaction:RR=0.38(95%CI)[0.30,0.47],P<0.00001<0.05,thecomparisonofadverseeventsbetweenthetwogroupswasstatisticallysignificant.Andtheadverseeventsof TMassistedwithwesternmedicineinimprovingdepression C in Prkinson’diseasewasbetterthanthecontrolgroup’s.aConclusion:Theefficacyofintegratedtraditional Cineseandwesternh medicineinthetreatmentofpatientswithdepression Prkinson’sdiseaseisbettera thanthatofwesternmedicinealoneintheeffectiverate,UPDRS,HAMD,HAMA,PDQ-39,SDS and other aspects.And It has less incidence of adverse reactions.However,becausethequalityoftheincludedliteraturesisnothigh,and therearepublicationbiasorotherfactors.Itmayneedtobeverifiedbymorerigorous andhigherqualityclinicaltrials.