Integrated approach of scalp electroacupuncture and pharmacotherapy in managing Parkinson's disease: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials.

Background: Parkinson disease (PD) is a progressive neurological disorder that may be managed with therapies like scalp electroacupuncture (SEA). The combination of SEA and medication could potentially offer a new approach for managing PD symptoms. The systematic review and meta-analysis aimed to assess the combined impact of SEA and medication on PD through a comprehensive analysis of randomized clinical trials, focusing on outcomes like effective rate and various scores (total Unified Parkinson Disease Rating Scale (UPDRS), UPDRS III, and Webster).

Methods: It was conducted an unrestricted search from the beginning of each database until April 19, 2024, across 7 databases. These included 4 international databases: PubMed, Web of Science, Scopus, and Cochrane Library, and 3 Chinese databases: CNKI, VIP, and Wanfang. Review Manager, version 5.3 was used to calculate the mean difference (MD) or risk ratio along with a 95% confidence interval (CI). The Comprehensive Meta-Analysis version 3.0 was employed for conducting bias analyses, meta-regression, and sensitivity analyses.

Results: From 1422 records identified in the databases, 17 articles were included in both the systematic review and meta-analysis. The pooled risk ratio and its 95%CI in the intervention (SEA + medication) group compared to the control (medication) group for the effective rate is 1.24 [1.17, 1.32] with a P < .00001. The pooled MD and its 95%CI for the Webster score is -0.51 [-6.36, 5.35] with a P = .86. The pooled MD and its 95%CI for total UPDRS is 8.73 [2.88, 14.58] with a P = .003. The pooled MD and its 95%CI for UPDRS III is 4.42 [3.23, 5.61] with a P < .00001. The results for total UPDRS and UPDRS III showed that intervention reduced the severity and progression of PD in patients more than medication.

Conclusions: The intervention (SEA + medication) has shown significant effectiveness compared to the control (medication) in terms of the effective rate, total UPDRS, and UPDRS III in PD patients. However, it did not show a significant effect on the Webster score.