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. 2021 Jul 1;13:676827. doi: 10.3389/fnagi.2021.676827

Table 1.

Characteristics of the included clinical trials involving acupuncture related therapy of Parkinson's Disease.

References Conducting country Age (y) Sex (F/M) Disease duration (y) Experiment group Control group Frequency (period) Outcome measures Results Adverse events (group: number)
Bee venom acupuncture
Cho S. Y. et al. (2018) Korea A. 64.42 ± 8.24
B. 61.33 ± 8.20
C. 64.07 ± 6.33		 A. 10/14
B. 16/8
C. 5 /10		 A. 5.08 ± 3.68
B. 5.92 ± 4.18
C. 4.53 ± 3.25		 A. AT+BVA
B. SA +saline		 C.CM 2 times a week for 12 weeks 1. UPDRSII+III
2. UPDRS II
3. UPDRS III
4. PIGD
5. PDQL
6. BDI
7. MXE
8. DCL		 1.A>C, P = 0.001 A>B, P = 0.444
2.A>C, P = 0.001 A>B, P = 0.257
3. A>C, P = 0.008 A>B, P = 0.793
4.A>C, P = 0.001 A>B, P = 0.244		 Mild pain or slight bleeding after AT; mild itchiness or mild swelling after BVA
Hartmann et al. (2016) France A. 60.3;15
B. 63.3;8 (Median; Interquartile range)		 A. 12/8
B. 8/12		 A. 5.9;4.4
B. 5.6;4 (Median; Interquartile range)		 A. BV (100 ug) B. Placebo (NaCl 0.9%, 1 mL) Once a month over 11 months periods 1. UPDRSIII
2. BREF
3. MMS
4. LED
5. PDQ-39 scores
6. [123I]-FP-CIT		 Not significant Redness/itching at injection-site (B:6), insomnia (B:1, A:1), nausea (B:9, A:3), fatigue (B:10, A:2), dyskinesia (B:1, A:1), bradycardia (B:2, A:0)
Cho et al. (2012) Korea A. 55.0 (52.0, 66.0)B. 57.0 (49.0, 69.0)C. 57.0 (48.0, 68.0) (Median; Interquartile range) A. 8/5
B. 8/5C. 6/3		 A. 6.0 (3.0,9.0)
B. 5.0 (2.0,10.0)
C. 5.0 (4.0,7.0) (Median; Interquartile range)		 A. AT+CM
B. BVA+CM		 C.Waiting group (CM) Twice a week for 8 weeks 1. Total UPDRS (I–V)
2. UPDRSI
3. UPDRS II
4. UPDRS III
5. UPDRSIV
6. UPDRSV
7. UPDRSVI
8. BBS
9. 30-m walking time
10. steps to walk 30-m
11. PDQL
12. BDI		 1.3.4 B>C, P < 0.05 Itchiness (B:1) (eliminated from the study). No other serious adverse events reported
Acupoint injection
Liu et al. (2015) China A. 62.9 ± 8.4
B. 64.8 ± 8.1
C. 65.2 ± 9.8		 A. 16/29
B. 19/26
C. 20/25		 A. 6.4 ± 2.9
B. 5.8 ± 2.5
C. 6.0 ± 3.1		 A. AT+ Madopar
B. Acupoint injection of kakkonein+ Madopar		 C.Madopar 3 times a week (only Monday/ Wednesday/ Friday) for 8 weeks 1. UPDRSI
2. UPDRSII
3. UPDRSIII		 1. B>C, A>C, P < 0.05 A,B Not significant
2. B>A, B>C, A>C, P < 0.05		 NR
Abdominal acupuncture
Wen et al. (2008) China 62.14 ± 9.25 23/37 NR A. Abdominal AT+ Moxibustion n = 30 B. Madopar n = 30 Once daily, 3 times a week for 3 months 1. UPDRS Total (I–IV)
2. UPDRS
3. UPDRS II
4. UPDRS III
5. UPDRSIV		 1.3 A>B, P < 0.05 2.4.5 Not significant Ns
Self-acupressure
Yuen et al. (2020) China A. 63.77 ± 1.41
B. 64.64 ± 2.57		 A. 13/9
B. 10/4		 A. 8.41 ± 1.27
B. 8.64 ± 1.44		 A. conduction exercise and self-acupressure B. No additional treatment Once daily, twice at maximum for 8 weeks 1. CPDQ-39 total
2. CDQ total		 Not significant Leg bruising (A:1) Upper respiratory infection (A:1; B:1) Fall (A:1) Change of dosage of PD medication (A:1)
Catgut embedding
Zhu (2016) China NR NR NR A. acupoint catgut embedding +CM n = 31 B. CM n = 31 Every 15 days a time for 4 times 1. UPDRS 1.A>B, P < 0.05 NR
Hu et al. (2014) China A. 68.2 ± 1.2
B. 67.9 ± 5.4		 A. 10/30
B. 11/29		 A. 6.08 ± 9.5
B. 5.98 ± 6.36		 A. Bushenzhichan Decoction+ catgut embedding+Madopar B. Madopar Decoction: once daily for 3months Catgut embedding Once daily or every 3 days for 3 months 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRS-Total
5. DosageofMadopar		 1.2.3.4 A>B, P < 0.05 No abnormal changes in biochemical indices
Moxibustion
Shen et al. (2019) China A. 73.9 ± 11.5
B. 71.9 ± 11.4		 A. 15/21
B. 16/20		 A. 8.5 ± 1.6
B. 7.1 ± 1.5		 A. AT+Warming Needle Moxibustion+B B. CM+hemp seed soft capsule Every other day for 28 days 1. UPDRSII
2. UPDRSIII
3. constipation score
4. medication compliance		 1.2 A>B, P < 0.05 NR
Deng et al. (2014) China A. 58 ± 6.0
B. 60 ± 5.7		 A. 5/10
B. 6/9		 A. 4.1 ± 1.5
B. 4.6 ± 1.2		 A. ScalpEA+ Warming Needle Moxibustion+CM B. CM (Madopar+ Pramipexole) 8 weeks 1. UPDRS-Total
2. total efficiency of UPDRS		 1.A>B, P < 0.05 2.A>B, P < 0.01 NR
Shen et al. (2018) China A. 74 ± 11
B. 72 ± 11		 A. 12/18
B. 13/17		 A. 8.53 ± 1.55
B. 7.13 ± 1.47		 A. AT+ Warming Needle Moxibustion+B B. CM+hemp seed soft capsule Every other day for 4 weeks 1. BBS
2. PAC-QOL
3. UPDRS III		 1.2 A>B, P < 0.05 NR
Wu (2014) China 69.3 ± 11.3 NR 3.57 ± 1.21 A. mild moxibustion+ Madopar n = 33 B. Madopar n = 32 Once daily for 15 days 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV
5. UPDRS-Total
6. total efficiency of Webster score		 2.6 A>B, P < 0.05 NR
Zhang et al. (2005) China 51–78 (66.8) 25/29 2 years−9 years A. moxibustion (herbs-artitioned) +CM n = 54 B. CM n = 36 Every other day for 15 days as a course for 2 courses, resting for 2–3days between 2 courses 1. total efficiency of UPDRS 1.A>B, P < 0.05 NR
Herbal Decoction
Zhao (2019) China A. 55.76 ± 17.26
B. 57.54 ± 19.05		 A. 28/32
B. 26/34		 A. 5.87 ± 19.03
B. 5.37 ± 20.98		 A. AT+Shuyuzhi chan Decoction + Madopar B. Madopar+Fluoxetine Once daily for 8 weeks 1. HAMD
2. UPDRS
3. DA		 1.2.3 A>B, P < 0.05 NR
Huo et al. (2019) China A. 65.12 ± 8.25
B. 64.89 ± 8.17		 A. 15/26
B. 17/24		 A. 7.27 ± 1.81
B. 7.31 ± 1.76		 A. AT+GuiluerxianDecoction+CM B. CM (Madopar+Pramipexole) +Alprazolam Once daily for 4 weeks 1. SL/TST/AT
2. Nrem-S1–S4
3. PDSS
4. HAMD
5. UPDRS III
6. TCM symptom grading
7.5-HT
8. SP		 1–8 A>B, P < 0.05 NR
Cheng (2019) China A. 65.69 ± 5.21
B. 65.63 ± 5.23		 A. 17/28
B. 16/29		 A. 3.19 ± 1.22
B. 3.12 ± 1.23		 A. ScalpAT+Shaogan Dingchan Decoction+CM B. CM Once every other day, 3 times a week for 3 months 1. UPDRS-Total
2. patient satisfaction
3. complication rate
4. recurrence rate in 1 year		 1.A>B, P < 0.05 NR
Xiao and Zhang (2018) China A. 62.28 ± 7.43
B. 63.83 ± 7.62		 A. 19/29
B. 21/27		 A. 7.27 ± 3.24
B. 8.32 ± 3.57		 A. EA+Huangqibu shen Decoction+CM B. CM (Madopar) Once daily for 2 months 1. hs-CRP/TNF-/IL-6
2. MMSE
3. ADL		 1.A>B, P < 0.05 2.A>B, P = 0.013 3.A>B, P = 0.006 Chest distress (B:2) insomnia (B:1) anorexia (B:2) dizzy (A:1, B:2) drowsiness (A:1, B:2)
Hu (2018) China A. 66.60 ± 4.82
B. 66.42 ± 4.78		 A. 18/37
B. 20/35		 A. 14.70 ± 3.85
B. 14.62 ± 3.81(months)		 A. AT+Bushentongqiao Decoction+ Carbidopa B. Carbidopa Once daily for 6 months 1. TCM syndrome integral
2. UPDRSI/II/III
3.P DQ-39
4.SAS
5. SDS
6.IL-1β
7.IL-6
8.SOD
9.MDA		 1–9 A>B, P < 0.05 NR
Zhang and Jiang (2010) China A. 69.3 ± 7.6
B. 67.8 ± 9.1		 A. 15/17
B. 18/14		 A. 4.67 ± 2.10
B. 5.08 ± 1.32		 A. Bushenhuoxue Decoction+AT+ B B. Madopar Once daily for 3 weeks as a course for 3 courses, resting a week between 2 courses 1. UPDRSII
2. UPDRSIII
3. UPDRSIV
4. UPDRS-Total
5. H-YStage
6. Dosageof Madopar
7. total efficiency of UPDRS		 1.2.4 A>B, P < 0.05 3.Not significant NR
Acupuncture Treatment
Xu et al. (2020) China A. 61.7 ± 10.28
B. 61.95 ± 9.77		 A. 18/15
B. 16/21		 A. 3.52 ± 2.78
B. 3.26 ± 2.32		 A. EA+Madopar B. Madopar 4 days per week for 8 weeks 1. UPDRSI
2. UPDRS II
3. UPDRS III
4. UPDRSIV
5. Webster
6. PDSS
7. SDS		 1.A>B, P < 0.05
2. A>B, P = 0.121
3. A>B, P = 0.054
4. A>B, P < 0.05
5. A>B, P < 0.05
6. A>B, P = 0.001
7. A>B, P < 0.05		 No serious adverse events reported
Li Z. et al. (2018) China A. 65.79 ± 6.07
B. 62.85 ± 5.00
C. 62.17 ± 7.66		 A. 6/8
B. 6/7
C. 3/9		 A. 5.14 ± 3.32
B. 5.03 ± 4.73
C. 7.33 ± 4.62		 A. AT+CM
B. SA+CM		 C.WG+CM Twice weekly for 12 weeks 1. UPDRSII
2. UPDRS III
3. PIGD
4. fMRI: DC/ReHo/ALFF		 NR NR
Kong et al. (2017) China A. 66.4 ± 6.5
B. 62.9 ± 9.7		 A. 14/6
B. 13/7		 A. 87.2 ± 53.2
B. 50.1 ± 26.4 (months)		 A. AT B. SA Twice weekly for 5 weeks 1. MFI-General fatigue
2. MFI-Total 3.UPDRSIII
4. PDQ-39
5. GDS
6. ESS		 1.A>B, P = 0.09 2–6, Not significant 1.a skull fracture after a fall;
2. A pelvic fracture, also after a fall
3. exacerbation of anxiety
Kluger et al. (2016) USA A. 64.4 ± 10.3
B. 63.0 ± 13.0		 A. 17/30
B. 18/29		 NR A. AT+CM B. SA+CM Twice-weekly sessions at least 1 day apart for 6 weeks 1. MFIS-Total
2. MFIS-Physical
3. MFIS-Cognitive
4. MFIS-Psychosocial
5. UPDRS III
6. PDQ-39
7. HADS Anxiety
8. HADS-Depression
9. PDSS
10. ESS
11. AES		 Not significant Constipation (A:1)
Wang et al. (2016) China A. 61 ± 10
B. 62 ± 9
C. 61 ± 8		 A. 15/15
B. 14/16
C. 15/16		 A. 5.63 ± 1.83
B. 5.57 ± 1.55
C. 6.12 ± 1.31		 A. EA+Madopar (2/100 HZ)
B. EA+Madopar (100 HZ)		 C.Madopar 3 times per week for 90 days 1. UPDRS
2. TAS		 1.B>C, P < 0.01 2.B>C, P < 0.01 NR
Xie et al. (2016) China 71.51 ± 6. 06 47/61 5.7 ± 4. 1 A. AT+CM+Triple Viable Bacteria n = 53 B:CM+Triple Viable Bacteria n = 53 Once daily for 8 weeks 1. HAMD
2. UPDRSI
3. UPDRS II
4. UPDRSIII
5. UPDRSIV
6. UPDRS-Total		 1.A>B, P < 0.05 6.A>B, P < 0.05 NR
Toosizadeh et al. (2015) USA A. 69.8 ± 4.5
B. 71.0 ± 11.7		 A. 4/6
B. 3/2		 A. 3.0 ± 1.0
B. 2.9 ± 0.7		 A. EA (4 Hz or 100 Hz) B. ShamEA (non-acupuncture points, just turning on the light of the stimulator) Once a week for 3 weeks 1. GOGAPsway
2. GOGMLsway
3. GOGML/APsway
4. ankle sway
5. hip sway
6. ankle/hip.sway
7. SF-12(PCS)
8. SF-12(MCS)
9. ShortFES-I
10.VAS
11. UPDRS-Fall
12.UPDRS-Rigidity
13.UPDRSI
14.UPDRSII
15.UPDRS III		 10. Not significant11. A>B, P = 0.391
2.A>B, P =0.051
3. A>B, P < 0.011
4. A>B, P =0.021
5.A>B, P < 0.001		 NR
Wang et al. (2015) China A. 62.1 ± 8.7
B. 59.1 ± 12.4		 A. 15/13
B. 11/9		 A. 2.9 ± 2.9
B. 2.7 ± 2.3		 A. EA+CM (anti-Parkinsonian drugs) B. CM (anti-Parkinsonian drugs) Once every 3 days for 2 months 1. UPDRSII
2. UPDRSIII
3. UPDRSIV
4. H-Y Stage
5. MoCA
8. HAMD
9. PSQI
10. ADL
11. PDQ-39
12. NO/TNF-α/IL-1β/PGE2
13. DA/Ach/NE/5-HT		 2.A>B, P = 0.036
4.5.6.7.8. Not significant
9.A>B, P = 0.034		 NR
Chen et al. (2012) China A. 65.60 ± 3.79
B. 61.93 ± 3.67		 A. 11/19
B. 13/17		 A. 5.4 ± 1.75
B. 6.4 ± 2.15		 A. EA+B B. medication (MadoparandTolterodine) 6 times a week (except Sunday) for 6 weeks 1. frequency of average urination of 24 h
2. frequency of incontinence of 24 h
3. average urine volume at a time
4. UPDRSIII		 1.2.3.4 A>B, P < 0.05 Dry mouth, dry eye, blurred vision, decreased reaction/ intelligence/activity (A:3, B:12), Urinary retention (B:1), ALT, AST mild elevation (B:1)
Yang et al. (2006a) China 49–73 (63) 14/24 (Total) 8 months−6 years 1 month A. ScalpET+AT +B n = 19 B. medication (Benserazide-Levodopa) n = 19 Every other day for 10 times as 1 course for 4 courses, resting for 7 days between 2 courses 1. UPDRS
2. SODandcontene of peroxidation lipid		 1.2 A>B, P < 0.05 NR
Jiang X. M. et al. (2006) China A. 65.60 ± 3.78
B. 60.80 ± 3.63		 A. 7/8
B. 9/6		 A. 5.40 ± 1.75
B. 6.4 ± 2.14		 A. Scalp EA +Madopar B. Madopar 5 times 1 week for 6 weeks (total 30 times) 1.Webster
2. UPDRSIII		 1.Not significant
2.A>B, P < 0.05		 Pain on acupuncture area (A:1), Digestive disorders (B:5), On-off phenomenon (B:1)
Chang et al. (2008) China A. 58.2 ± 12.3
B. 57.6 ± 11.9		 A. 12/18
B. 11/19		 A. 3.4 ± 1.3
B. 3.6 ± 1.5		 A. AT+EA+ Madopar B. Madopar Once daily for 30 days 1. UPDRS 1.A>B, P < 0.05 NR
Zhang et al. (2020) China A. 52.16 ± 3.56
B. 55.32 ± 3.02		 A. 27/21
B. 22/26		 A. 4.46 ± 1.32
B. 4.12 ± 1.21		 A. EA+ Pramipexole B. Pramipexole 6 times a week for 8 weeks 1. UPDRS
2. HAMD
3. PDSS
4. YKL-40
5. BDNF		 1.2.3.4.5 A>B, P < 0.05 NR
Huang et al. (2020) China A. 62.25 ± 9.31
B. 61.94 ± 8.41		 A. 28/52
B. 30/49		 A. 3.71 ± 0.77
B. 3.59 ± 0.65		 A. AT+ medication B. medication (Madopar+Bazhen Decoction and Tianmagouteng Decoction) 6 times a week for 8 weeks 1. dysfunction of tremor syndrome
2. PDQ-39 SI
3. symptoms of syndrome of Qi and blood deficiency
4. UPDRSI-III
5. NMSQuest
6. NMSS		 1–5 A>B, P < 0.01 NR
Zhao and Wang (2019) China A. 66.63 ± 5.71
B. 64.85 ± 6.14		 A. 15/17
B. 15/16		 A. 4.5 ± 2.7
B. 4.2 ± 2.9		 A. AT+B B. CM+ Paroxetine 6 times a week for 4 weeks 1. HAMD
2. UPDRS		 1.A>B, P = 0.000
2.A>B, P = 0.019		 NR
Li et al. (2020) China A. 71 ± 5
B. 68 ± 7		 A. 16/14
B. 17/13		 A. 6.2(6.49,9.16)
B. 6.00(6.67,9.57)		 A. ScalpEA+AT+CM B. CM 3 times a week for 12 weeks 1. UPDRS
2.20-m walking time and average interval
3. PDQ-39		 1,3 A>B, P < 0.05 NR
Wang et al. (2019) China A. 66.24 ± 6.09
B. 65.72 ± 5.67
C. 65.43 ± 6.82		 A. 18/14
B. 17/15
C. 15/16		 A. 6.55 ± 3.32
B. 7.15 ± 3.47
C. 6.82 ± 2.98		 A. AT+ Madopar
B. AT		 C. Madopar Once daily for 30 days 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV
5. UPDRS-Total
6. MoCA
7. MMSE
8. ADL		 1. A>C, P < 0.01 A>B, P < 0.05, B>C, P < 0.05
2.3.4.5 A>C, P < 0.05, A>B, P < 0.05
5. B>C, P < 0.05
6.7. A>C, P < 0.05,
8. A>C, P < 0.01, A>B, P < 0.05		 NR
Li and Wang (2018) China A. 72.16 ± 5.41
B. 73.36 ± 6.18		 A. 11/19
B. 16/14		 A. 5.62 ± 2.31
B. 5.14 ± 3.14 (months)		 A. AT+ Madopar B Madopar Once daily for 6 weeks 1. MoCA
2. MMSE		 1.2 A>B, P < 0.05 NR
Lin Z. C. et al. (2018) China A. 58.3 ± 4.6
B. 59.2 ± 4.4		 A. 18
B. 17		 A. 3.3 ± 0.9
B. 3.2 ± 1.0		 A. ScalpEA+B B. Donepezil + Cognitive training+CM 6 times a week for 6 weeks 1. TMT-A/B
2. MOCA
3. UPDRSII
4. UPDRSIII		 1.2.3.4 A>B, P < 0.05 Dizzy (A:1, B:1) tremor progress (A:1) stomach upset (B:1)
Wang et al. (2018) China A. 56.0 ± 5.6
B. 55.0 ± 6.1		 A. 10/20
B. 8/22		 A. 7.0 ± 1.5
B. 8.0 ± 2.0		 A. ScalpEA+CM B. CM (Madopar) 5 times a week for 6 weeks 1. UPDRS 1. A>B, P < 0.05 NR
Li G. S. et al. (2018) China A. 53.64 ± 7.18
B. 52.98 ± 7.52		 A. 20/19
B. 21/18		 A. 2.10 ± 1.34
B. 2.08 ± 1.52		 A. EA+Madopar B. Madopar 3 times a week for 12 weeks 1. UPDRS 1. A>B, P < 0.05 NR
Lin D. et al. (2018) China A. 63.4 ± 4.3
B. 61.6 ± 5.8		 A. 18/12
B. 20/10		 A. 5.3 ± 2.6
B. 4.7 ± 2.3		 A. AT+CM B. CM Once daily for 4 weeks 1. UPDRSI
2. UPDRSII
3. UPDRSIII		 1.2.3. Not significant
4.5.6.A>B, P < 0.05		 NR
4. UPDRSIV
5. UPDRS-Total
6. WOQ-9
Liu et al. (2018) China A. 64.68 ± 7.32
B. 63.78 ± 7.51		 A. 24/29
B. 26/27		 A. 5.87 ± 2.54
B. 5.66 ± 2.78		 A. EA+AT+ Carbidopa B. Carbidopa Once daily for 3 months 1. MDA
2.SOD
3.CystainC
4. UPDRS
5. PDQ-39		 1–5 A>B, P < 0.05 NR
Sheng and Guo (2018) China A. 60.28 ± 3.15
B. 61.07 ± 3.28		 A. 18/20
B. 19/19		 NR A. AT+ Madopar B. Madopar Once daily for 15 days as 1 course for 3 courses, resting for 5–7 days between 2 courses 1. dosage of Madopar
2. clinical effects
3. assessmentsresultsof motor function		 1.2.3 A>B, P < 0.05 NR
Qin et al. (2016) China A. 45-79
B. 46-65		 A. 15/30
B. 14/16		 NR A. EA+ Madopar B. Madopar Once daily for 20 days 1. dosageofMadopar 1. A>B, P < 0.05 NR
Tian et al. (2016) China A. 62.4 ± 5.1
B. 60.8 ± 4.4		 A. 9/41
B. 12/38		 A. 3.3 ± 0.5
B. 3.6 ± 0.4		 A. EA+B B. Madopar+Fluoxetine Every other day for 3 months 1. HAMD
2. BDNF		 1.2. A>B, P < 0.05 NR
Yang (2016) China A. 73.45 ± 7.21
B. 76.86 ± 8.24		 A. 6/14
B. 9/11		 NR A. EA+ levodopa B. levodopa Once daily for 30 days 1. UPDRS
2. Webster		 1. A>B, P < 0.05
2. Not significant		 NR
Zhang (2016) China A. 58.4 ± 6.9
B. 54.6 ± 7.6		 A. 16/24
B. 18/22		 A. 28.3 ± 10.2
B. 26.4 ± 12.8(months)		 A. AT+ Madopar B. Madopar Once daily for 45 days 1. UPDRS 1. A>B, P < 0.05 NR
Zhou et al. (2016) China A. 69.2 ± 4.6
B. 70.1 ± 4.4		 A. 33/30
B. 32/32		 A. 7.43 ± 3.85
B. 9.32 ± 3.45		 A. Scalp EA+ Madopar B. Madopar Once daily for 8 weeks 1. UPDRSII+III
2. PDSS		 1.2 A>B, P < 0.05 Dizzy (A:2) epigastric discomfort (A:1) drowsiness, (A:1) hypotension (A:1, B:3) insomnia (B:3) chest distress (B:3) constipation (B:2) paropsia (B:1) anorexia (B1)
Liu B. (2016) China A. 65.65 ± 4.15
B. 65.59 ± 4.18		 A. 18/21
B. 16/19		 A. 4.41 ± 2.01
B. 4.33 ± 2.04		 A. EA+ Madopar B. Madopar 3 times a week for 12 weeks 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV		 1.2.3.4 A>B, P < 0.05 NR
Liu and Wu (2016) China A. 59 ± 8
B. 63 ± 4		 A. 11/9
B. 8/12		 A. 3.4 ± 3.2
B. 4.1 ± 2.7		 A. ScalpEA+ Madopar B. Madopar 3 times a week for 30 times 1. frequency of static tremor (EMG)
2. UPDRSIII		 1.2 A>B, P < 0.05 NR
Suo et al. (2015) China A. 67.2 ± 5.6
B. 66.8 ± 5.8		 A. 12/23
B. 10/25		 NR A. Neck Points plus ScalpeEA+ Madopar B. Madopar 6 times a week for 4 weeks 1. UPDRS
2. total efficiency of Webster		 1.2. A>B, P < 0.05 NR
Huang et al. (2015) China 62.7 ± 2.5 32/88 NR A. Transcranial repetitiveAT (Dance tremor area)+ Madopar n = 40
B. AT (Dance tremor area)+ Madopar n = 40		 C.Madopar n = 40 Once daily for 8 weeks 1. UPDRS NR NR
Zhang (2015) China A. 63 ± 9
B. 66 ± 6		 A. 12/20
B. 10/18		 A. 26.00 ± 11.97
B. 27.86 ± 9.59 (months)		 A. AT+ Madopar B. Madopar Once daily for 30 days 1. UPDRS
2. total efficiency of UPDRS		 1.2 A>B, P < 0.05 NR
Huang et al. (2014) China A. 61 ± 8
B. 59 ± 9		 A. 7/13
B. 8/12		 A. 34 ± 8
B. 35 ± 6		 A. Scalp AT+ Madopar B. Madopar 5 times a week for 4 weeks 1. UPDRS
2. PSQI		 1. A>B, P < 0.001
2. A>B, P < 0.005		 NR
Zhou et al. (2014) China A. 63.1 ± 4.54
B. 60.7 ± 3.19		 A. 14/16
B. 13/17		 A. 4.73 ± 1.68
B. 5.13 ± 2.04		 A. AT+ Madopar B. Madopar Once daily for 10 days as 1 course for 4 courses, resting for 3 days between 2 courses 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV		 1.2.3. A>B, P < 0.05 NR
Gu et al. (2013) China A. 66 ± 8
B. 70 ± 8		 A. 13/10
B. 10/15		 A. 4.44 ± 3.32
B. 4.56 ± 3.11		 A. EA+ Madopar B. Madopar 3 times a week for 12 weeks 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV
5. UPDRS-Total		 1.2.4.5 A>B, P < 0.05
3. Not significant		 NR
Xia et al. (2013) China A. 71.84 ± 7.22
B. 71.93 ± 8.12		 A. 8/22
B. 10/20		 A. 6.7 ± 3.0
B. 5.8 ± 4.0		 A. EA+ Madopar+Fluoxetine B. Madopar+Fluoxetine Every other day for 3 months 1. HAMD
2. DA
3. total efficiency of HAMD		 1.2.3. A>B, P < 0.05 NR
Chen et al. (2013) China A. 57–71 (62.00)
B. 55–75 (65.05)		 A. 14/16
B. 14/17		 A. 4.8
B. 4.6 (average)		 A. AT+ Madopar B. Madopar Every other day for 3 months 1. UPDRS
2. dosageof Madopar
3. total efficiency of UPDRS		 1.3. A>B, P < 0.05
2. Not significant		 No abnormal changes in biochemical indices
Liu and Jiang (2013) China A. 52 ± 8
B. 51 ± 6		 A. 10/12
B. 11/10		 A. 18.86 ± 7.95
B. 19.76 ± 6.93 (months)		 A. AT+ Madopar B. Madopar Once daily for 30 days 1. UPDRS
2. H-Y stage		 1.2 A>B, P < 0.05 NR
Hou et al. (2013) China A. 67 ± 10
B. 67 ± 8		 A. 14/16
B. 12/18		 A. 5.17 ± 1.84
B. 5.40 ± 1.75		 A. EA+ Madopar B. Madopar 3 times a week for 3 months 1. UPDRS
2. TAS		 1.2 A>B, P < 0.01/0.05 NR
Zhuang and Zhuang (2012) China A. 61.27 ± 4.58
B. 61.21 ± 4.48		 A. 12/19
B. 14/17		 A. 5.28 ± 3.44
B. 4.98 ± 2.86		 A. AT+ Madopar B. Madopar Once daily for 5 days as 1 course for 8 weeks, resting for 2 days between 2 courses 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV
5. UPDRS-Total		 1.2,3,4,5 A>B, P < 0.05 NR
Xia et al. (2011) China A. 71.94 ± 8.81
B. 71.33 ± 7.21		 A. 8/14
B. 3/15		 NR A. EA+ Madopar B. Madopar Once daily for 20 days 1. UPDRS
2. Webster
3. total efficiency of Webster		 1. Not significant
2. A>B, P < 0.05		 NR
Ren et al. (2011) China A. 59.1 ± 12.1
B. 58.2 ± 11.9		 A. 38/52
B. 41/49		 A. 1.8 ± 0.3
B. 1.9 ± 0.4		 A. AT+ Madopar B. Madopar Once daily for 30 days 1. UPDRSI
2. UPDRSII
3. UPDRSIII
4. UPDRSIV
5. UPDRS-Total
6. total efficiency of UPDRS		 2.3.4.5.6 A>B, P < 0.05 NR
Huang et al. (2009) China A. 65.60 ± 3.78
B. 60.80 ± 3.63		 A. 7/8
B. 9/6		 A. 5.40 ± 1.75
B. 6.4 ± 2.14		 A. Scalp EA+ Madopar B. Madopar Once daily for 6 times a week, for 5 weeks 1. UPDRSIII
2. SPECT-values of rCBF		 1. A>B, P < 0.05 NRContinue to next page
Yang et al. (2006b) China 49–73 (63.2) 11/15 8 months−5 years 7 months A. ScalpEA+AT+ Madopar n = 13 B. Madopar n = 13 Once daily for 10 days as a course for 4 courses, resting 7 days between 2 courses 1. UPDRS
2. TCM syndrome integral
3. total efficiency of UPDRS		 3. A>B, P < 0.05 Mild drymouth Nausea, and dizziness (A:1), mild dizziness (B:2), nausea (B:3), subcutaneous hematocele (B:2)
Zhang et al. (2013) China A. 66.80 ± 9.73
B. 66.67 ± 8.32		 A. 14/17
B. 15/15		 A. 8.92 ± 2.29
B. 7.79 ± 2.15		 A. AT (Thick needle+ Madopar B. Madopar 3 times a week for 3 months 1. UPDRS
2. TAS		 1.2 A>B, P < 0.01 NR

Ach, Acetylcholine; AES, Apathy Evaluation Scale; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase; ALFF, Amplitudes of low-frequency fluctuation; AT, Acupuncture Treatment; BVA, bee venom acupuncture; BV, bee venom; BBS, Berg balance scale; BSS, The Bristol Stool Scale; BI, Barthel index; BDI, Beck Depression Inventory; CM, Conventional medication; COGAP sway, anterior-posterior central of gravity sway; COGML sway, medial-lateral central of gravity sway; COGML/AP sway, medial-lateral central of gravity sway to anterior-posterior sway; CDQ, custom-designed questionnaire; DA, dopamine; DCL, directional control; DC, degree centrality; EA, Electro-acupuncture; ESS, Epworth Sleepiness Scale; fMRI, functional Magnetic resonance imaging; FES-I, Short Falls Efficacy Scale-International; HADS, Hospital Anxiety and Depression Scale; HAMA, Hamilton Anxiety Scale; HAMD, Hamilton Depression Scale; H and Y, Hoehn and Yahr; IL-1β, the levels of interleukin-1β;IL-6, interleukin-6; MDA, malondialdehyde; MMSE, Mini-mental status examination; MoCA, Montreal cognitive assessment; MFI, the Multidimensional Fatigue Inventory; MFIS, Modified Fatigue Impact Scale; MXE, maximum excursion; NO, nitric oxide; NE, norepinephrine; NR, not reported; PAC-QOL, Patient Assessment of Constipation Quality of Life scale; PDQL, Parkinson's Disease Quality of Life Questionnaire; PDQ-39, 39-item Parkinson Disease Questionnaire; PDSS, Parkinson's Disease Sleep Scale; PIGD, postural instability and gait disturbance; PSG, polysomnography; PSQI, Pittsburgh Sleep Quality Index; PGE2, prostaglandinE2; ReHo, regional homogeneity; SA, sham acupuncture; SAG, sham acupuncture group; SAS, self-rating Anxiety Scale.; SD, standard deviation; SDS, self-rating Depression Scale; SF-12 (MCS), mental component summary of the SF-12 health survey; SF-12 (PCS), Physical component summary of the SF-12 health survey; SOD, superoxide dismutase; SP, substance P; TAG, true acupuncture group; TAS, Tension Assessment Scale; TCM, Traditional Chinese medicine; TNF- α, tumor necrosis factor- α; UPDRS, Unified Parkinson's Disease Rating Scale; UPDRS I, behavior and mood subscale of the Unified Parkinson's Disease Rating Scale; UPDRS II, activities of daily living subscale of the Unified Parkinson's Disease Rating Scale; UPDRS III, motor symptoms caused by Parkinson's Disease subscale of the Unified Parkinson's Disease Rating Scale; UPDRS IV, complications of therapy subscale of the Unified Parkinson's Disease Rating Scale; VAS, visual analog scale; 5-HT, 5-hydroxytryptamine; WG, waiting group; WHOQOL-BREF, Brief table of quality of Life measurement Scale (WHO);WOQ, The incidence rate of Wearing-off Questionnaire.

*Studies denoted as a or b distinguishes those published by the same first author and in the same year.