针刺结合康复训练治疗脑卒中后肩痛的系统评价  

The systematic evaluation of acupuncture combined with rehabilitation training For the treatment of post-strokeshoulder pain

作　　者：林郁芬 李铮[1] 富晶晶[1] 刘霞[1] 

机构地区：[1]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2015年第11期1004-1009,共6页Journal of Nurses Training

摘　　要：目的系统评价针刺结合康复训练治疗脑卒中后肩痛的有效性。方法计算机检索Cochrane图书馆、JBI循证护理数据库、PubMed、EMbase、CBM、万方和CNKI数据库,查找关于针刺结合康复训练治疗脑卒中后肩痛的相关研究文献,检索时限均从建库至2015年2月。由3位评价员按纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.1软件进行Meta分析。结果共纳入13个RCT研究,869例患者。Meta分析结果显示:针刺结合康复训练治疗脑卒中后肩痛在减轻疼痛[95%CI(0.92,2.09),P<0.00001]、改善上肢运动功能[95%CI(1.16,11.60),P=0.02]和日常生活活动能力[95%CI(3.00,19.49),P=0.007]方面优于单纯康复训练法,差异均有统计学意义。结论现有证据表明,针刺结合康复训练治疗脑卒中后肩痛较单纯康复训练方法更有效。鉴于纳入研究数量有限,上述结论尚需开展更多研究予以验证。Objective To summarize and evaluate the effects of acupuncture combined with rehabilitation training for post‐stroke shoulder pain（PSSP） .Method Randomized controlled trials （RCTs） involving the effects of acupunc‐ture combined with rehabilitation training for PSSP ,published from the beginning of databases to February 2015 , were obtained from the Cochrane Library ,JBI（Joanna Briggs Institute） ,evidence‐based nursing database ,PubMed , EMbase ,CBM ,Wanfang Data and CNKI Databases .Result 13 RCTs involving 869 patients met the inclusion crite‐ria .Meta‐analysis showed that acupuncture combined with rehabilitation training made significant differences on pain improvement[95% CI（0 .92 ,2 .09） ,P＆lt;0 .00001] ,upper extremity motor function[95% CI（1 .16 ,11 .60） ,P=0 .02] and the activity of daily life[95% CI （3 .00 ,19 .49） ,P=0 .007] .Conclusion Acupuncture combined with reha‐bilitation training is more effective than rehabilitation training alone for PSSP .Since the quantity of inclusive studies is limited ,it is recommended that more future trials be conducted on this topic to verify the conclusion .

关 键 词：针刺 康复训练 脑卒中 肩痛 META分析 

分 类 号：R471[医药卫生—护理学] R473.54[医药卫生—临床医学]