针灸结合康复疗法治疗痉挛型脑瘫临床疗效Meta分析  

Meta-analysis of clinical efficacy of the treatment combined with acupuncture and rehabilitation therapy for spastic cerebral palsy

作　　者：安晓菲 李璟[1] 黄馨云 赵爽 王丽雯 李申[1] AN Xiaofei;LI Jing;HUANG Xinyun(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]四川省乐山市中医医院,乐山614000

出　　处：《陕西中医》2019年第10期1477-1482,共6页Shaanxi Journal of Traditional Chinese Medicine

摘　　要：目的:对针灸结合康复疗法治疗痉挛型脑瘫的随机对照试验进行Meta分析,以明确针灸结合康复疗法治疗痉挛型脑瘫的临床疗效。方法:通过全面检索Web of Science、Science Direct、Pubmed、中国知网数据库、万方数据库、重庆维普中文科技期刊数据库、中国生物医学文献数据库网络版等数据库中已发表的关于针灸结合康复疗法治疗痉挛型脑瘫临床随机对照试验的相关文献,运用系统评价方法,按照排除纳入标准筛选文献,整理资料,评价文献质量,提取数据。并采用改良的Jadad评分量表进行质量评价、采用RevMan5.3软件进行Meta分析。结果:研究共纳入18个随机对照试验,共含1498例患者。Meta分析结果显示,针灸结合康复疗法治疗痉挛型脑瘫的总有效率明显优于对照组[OR=4.01,95%CI(2.95,5.46),Z=8.83,P<0.01],针灸结合康复疗法治疗痉挛型脑瘫在改善MAS分级[MD=-0.51,95%CI(-0.68,-0.34),Z=5.89,P<0.01]和提高GMFM评分[MD=6.82,95%CI (3.69,9.94),Z=4.28,P<0.01]方面明显优于对照组。结论:针灸结合康复疗法比单纯康复疗法治疗痉挛型脑瘫临床疗效更好,可明显改善患儿肌张力、提高粗大运动功能,但还需要更多高质量、规范化的临床随机对照试验进一步验证支持。Objective:To conduct a meta-analysis on the randomized controlled trial of the treatment combined with acupuncture and rehabilitation therapy for spastic cerebral palsy,so as to determine its clinical efficacy. Methods:Relevant literature of clinical randomized controlled trials of the treatment combined with acupuncture and rehabilitation therapy for spastic cerebral palsy published in database such as Web of Science,Science Direct,Pubmed,CNKI Database,Wanfang Database,Chongqing Weipu Chinese Scientific Journal Database and China Biomedical Literature Database was comprehensively searched. The literature was screened and sorted out according to exclusion criteria through systematic evaluation method,the quality of the literature was evaluated,and the data was extracted. Quality assessment was conducted through the improved Jadad rating scale,and meta-analysis was carried out using RevMan 5.3 software. Results:16 randomized controlled trials were included in the study,involing 1,402 patients. Meta-analysis results showed that the total effective rate of the treatment combined with acupuncture and rehabilitation therapy for spastic cerebral palsy is significantly superior to that of the control group [OR=4.01,95% CI(2.95,5.46),Z=8.83,P<0.01],and that the treatment is significantly superior to the control group in improving MAS classification [MD=-0.51,95% CI(-0.68,-0.34),Z = 5.89,P <0.01] and the GMFM score [MD= 6.82,95% CI(3.69,9.94),Z =4.28,P<0.01]. Conclusions:The treatment combined with acupuncture and rehabilitation therapy for spastic cerebral palsy has better clinical efficacy than pure rehabilitation therapy,and it can significantly improve children’s muscle tension as well as the gross motor function. However,more high-quality and standardized randomized controlled clinical trials are required for further validation.

关 键 词：针灸 康复 痉挛型 脑瘫 META分析 

分 类 号：R742.3[医药卫生—神经病学与精神病学]