针刺拮抗肌治疗中风后痉挛性瘫痪系统评价  

Systematic Evaluation and Meta-analysis of Acupuncture Antagonistic Muscle Therapy for Spastic Paralysis after Stroke

作　　者：王蕊[1] 王恩龙[2] WANG Rui;WANG Enlong(Liaoning University of Traditional Chinese Medicine, Liaoning Shenyang 110032, China;Affiliated Hospital of Liaoning University of traditional Chinese Medicine, Liaoning Shenyang 110032, China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110032 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中医药临床杂志》2019年第7期1291-1296,共6页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:系统评价针刺拮抗肌治疗中风后痉挛性瘫痪的临床疗效。方法:检索中国学术期刊网络出版总库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊服务平台(VIP)、万方数据库、Pubmed数据库、Cochrane Library从建库到2019年3月关于针刺拮抗肌治疗中风后痉挛性瘫痪的中、英文文献。2名研究员对检出文献进行整理,依据Corchrane协作网偏倚风险评价工具进行偏倚风险评估,选用RevMan5.3软件进行Meta分析。结果:最终纳入文献10篇,共718例患者。Meta分析结果提示,临床疗效评定治疗组疗效优于对照组RR=1.28,95%CI[1.17,1.40];改良的Ashworth量表(MAS)评定,治疗组疗效优于对照组MD=-0.78,95%CI[-1.29,-0.27];简式Fugl-Meyer评分法(FMA)评定治疗组疗效优于对照组MD=6.28,95%CI[4.48,8.07],差异均具有统计学意义;改良Barthel指数(MBI)评定检验异质性较大,采用描述性分析,治疗组疗效均优于对照组。结论:针刺拮抗肌对于改善中风后痉挛性瘫痪有一定疗效,但鉴于多种偏倚因素对本次研究结果的影响,仍需更多高质量临床研究,为临床提供证据支持。Objective:To systematically evaluate the clinical efficacy of acupuncture antagonistic muscle in the treatment of spastic paralysis after stroke.Methods:Searching Chinese Acacdemic Journals Network Publishing Library(CNKI),China Biomedical Literature Database(CBM),VIP Chinese Journal Service Platform(VIP),Wanfang Database,Pubmed Database,C.ochrane Library from the establishment of the library to March 2019 Chinese and English literature on acupuncture antagonistic muscle therapy for spastic paralysis after stroke.Two researchers sorted out the detected documents,conducted a bias risk assessment based on the Corchrane Collaboration Network bias risk assessment tool,and selected RevMan5.3 software for meta-analysis.Results:A total of 10 articles were included in the literature,with a total of 718 patients.Meta-analysis results suggested that the clinical efficacy of the treatment group was better than the control group RR = 1.28,95% CI[1.17,1.40];the modified Ashworth scale(MAS),the treatment group was better than the control group MD=-0.78,95% CI[-1.29,-0.27];the simplified Fugl-Meyer score(FMA)was better than the control group MD=6.28,95% C.l[4.48,8.07],the difference was statistically significant;The Barthel index(MBI)assessment test was heterogeneous.Descriptive analysis showed that the treatment group was better than the control group.Conclusion:Acupuncture antagonistici muscle has a certain effect on improving spastic paralysis after stroke.However,in view of the influence of various bias factors on the results of this study,more high-quality clinical studies are needed to provide evidence support for the clinic.

关 键 词：拮抗肌 针刺 中风 痉挛性瘫痪 系统评价 META分析 

分 类 号：R255.2[医药卫生—中医内科学]