针刺治疗脑卒中后痉挛性瘫痪疗效比较的系统评价与Meta分析  

Acupuncture Therapy for Post-Stroke Spastic Paralysis:A Systematic Review and Meta-Analysis

作　　者：汪伟[1] 柴铁劬[1] 王春[1] 向乔[1] 

机构地区：[1]广州中医药大学,广东广州510405

出　　处：《成都中医药大学学报》2016年第3期117-122,共6页Journal of Chengdu University of Traditional Chinese Medicine

摘　　要：目的:系统评价针刺治疗脑卒中后痉挛性瘫痪的疗效。方法:电子检索国内外数据库中针刺治疗脑卒中后痉挛性瘫痪的随机对照试验(Randomized Controlled Trial,RCT),并由两名评价者按照Cochrane Handboo5.1.0中的方法独立进行文献筛选和质量评估,运用Rev Man5.3软件进行数据统计和Meta分析。结果:最终纳入15个RCT,共包括940例患者。Meta分析显示:(1)有效率:试验组高于对照组,有统计学意义[OR=1.88,95%CI(1.35,2.61)];(2)MAS评分:针刺(综合)组疗效优于康复组,有统计学意义[WMD=-0.58,95%CI(-0.77,-0.39)];(3)FMA评分:试验组疗效优于对照组,有统计学意义[WMD=10.90,95%CI(8.69,13.11)]。结论:针刺治疗脑卒中后痉挛性瘫痪有一定的疗效,在与康复结合时更能凸显优势。但是由于纳入文献研究质量不足,目前不能对其疗效得出肯定性结论,需要以更多高质量的多中心随机对照试验进一步证实。Objective： To evaluate the effects of acupuncture on post-stroke spastic paralysis. Methods： Randomized controlled trials （RCTs） involving acupuncture therapy in the treatment of Post-stroke Spastic Paralysis were identified from domestic and foreign databases. Data were extracted and evaluated by two reviewers independently according to the method recommended by the Cochrane HandbookS. 1.0. The RevManS. 3 software was used for data analyses. Results： A total of 15 trials involving 940 patients were included. Meta-analyses showed that （ 1 ） the clinical effective rate in the Intervention group was superior to that in the controlled group [ OR = 1.88, 95% CI （ 1.35, 2.61 ） ] ; （2） MAS Rating in the acupuncture combined therapy group was better than that in the re- habilitation group [ WMD = -0. 58, 95% CI （ -0.77, -0. 39） ] ; （3） FMA score in the Intervention group was higher than that in the controlled group [WMD = 10. 90, 95% CI （8.69, 13.11 ）]. Conclusion： Acupuncture therapy may be effective for Post-stroke Spastic Paralysis, especially in combination with rehabilitation. But, a reliable conclusion can not be drawn from the present data because of the defects of trials in methodological quality. Therefore, it is necessary to perform more multi-central RCTs of high quality in future, to further confirm the effects.

关 键 词：针刺 脑卒中后遗症 痉挛 系统评价 META分析 随机对照试验 

分 类 号：R245.3[医药卫生—针灸推拿学] R743.3[医药卫生—中医临床基础]