针刺治疗中风后痉挛性瘫痪的系统评价  

Systematic evaluation of acupuncture for treatment of post-stroke spastic paralysis

作　　者：祁营洲[1] 傅立新[2] 熊俊[1] 王再岭[1] 牟蛟[1] 卢引明[1] 

机构地区：[1]天津中医药大学 [2]天津中医药大学第一附属医院针灸部

出　　处：《中国针灸》2009年第8期683-688,共6页Chinese Acupuncture & Moxibustion

基　　金：国家科技部"十一五"科技支撑计划课题项目:2006BAI12B02-2

摘　　要：对针刺治疗中风后痉挛性瘫痪的随机对照试验(RCT)或半随机对照试验(quasi-RCT)按Cochrane协作网推荐的方法进行系统评价。14篇中文文献978例患者满足纳入标准,但均为低质量试验。纳入的9个试验进行Meta分析结果显示:Ashworth评分、Carr-Shepherd运动评分、神经功能缺损程度评分、髋内收肌张力评分中试验组和对照组均无差别,而Fugel-Meyer评分中1项研究、Barthel指数评分中3项研究试验组优于对照组。由于纳入研究数量和质量上的缺陷,尤其是缺乏远期功能性结局指标,虽显示针刺有改善中风后痉挛性瘫痪的趋势,无不良反应,但目前尚不能对其疗效得出肯定结论,因此开展更多高质量、多中心的RCT非常必要。Objective To evaluate the effects of acupuncture on post-stroke spastic paralysis. Methods A sys tematic evaluation including all the relavant randomized controlled trials （RCTs） or quasi-RCTs of acupuncture and moxibustion for treatment of post-stroke spastic paralysis were carried out according to the method recommended by the Cochrane Collaboration. Results Nine hundred and seventy-eight patients being included in fourteen papers met the enrolled criteria. However, their methodological quality was relatively poor. Meta-analysis of nine trials indica ted that there was no significant difference between the treatment groups and the control groups in Ashworth scores, Cart-Shepherd scores, nerve defect scores and hip adductor tension scores. Whereas the Fugel-Meyer scores in one trial and the Barthel scores in three trials were better in the treatment groups than those of the control group. Conclusion A reliable conclusion can not be drawn from the present data because of the defects in methodological quality and insufficient numbers of trials, especially lack the long-term terminal outcomes, although it appears a tedency that acupuncture can improve the conditions of post-stroke spastic paralysis. Therefore, it is necessary to perform more multi-central RCTs of high quality in future.

关 键 词：针刺疗法 中风后遗症 四肢麻痹 痉挛 评价研究 

分 类 号：R246.6[医药卫生—针灸推拿学]