体外冲击波治疗脑卒中后痉挛有效性及安全性的系统评价  

The efficacy and safety of extracorporeal shock wave therapy in treating post-stroke spasticity:A systematic review

作　　者：刘维红[1] 刘涛[2] 陈强[1] 张杰[3] Liu Weihong;Liu Tao;Chen Qiang;Zhang Jie(Department of Traditional Chinese Medicine,Tianjin No.4 Central Hospital,Tianjin 300143,China;Department of Encephalopathy,Nankai Hospital,Tianjin 300100,China;Department of Acupuncture,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tiajin 300100,China)

机构地区：[1]天津市第四中心医院中医科,300143 [2]天津市南开医院脑病科,300100 [3]天津市中医药大学第一附属医院针灸科,300100

出　　处：《中华物理医学与康复杂志》2020年第3期255-264,共10页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：天津市卫生和计划生育委员会中医中西医结合科研项目(2015054)。

摘　　要：目的系统评价体外冲击波治疗脑卒中后痉挛的临床疗效和安全性。方法计算机检索PubMed、Embase、中国知网等数据库中有关体外冲击波治疗脑卒中后痉挛的随机对照试验(RCT),按纳入与排除标准选择文献并进行资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果共纳入12项研究,536例患者。Meta分析结果显示:体外冲击波对脑卒中后指屈肌、腕屈肌以及肱二头肌痉挛改善的即刻效应和短期效应均比对照组更具优势[加权均数差(WMD)=-0.84,95%置信区间(CI)为(-1.03,-0.65),P<0.01];体外冲击波对脑卒中后手腕运动功能的改善与对照组相比并无优势[WMD=0.95,95%CI(-0.16,2.5),P=0.23];暂未有证据显示其对下肢运动功能的改善优于对照组[WMD=-1.33,95%CI(-7.98,5.32),P=0.69]。结论体外冲击波可以有效降低脑卒中后痉挛的程度,安全性好,可作为一种辅助治疗方法。Objective To evaluate the efficacy and safety of extracorporeal shock wave(ESW)treatment in cases of post-stroke spasticity.Methods Reports of randomized and controlled trials of extracorporeal shock wave therapy in treating post-stroke spasticity were searched for in the PubMed,Embase and China Knowledge Infrastructure databases.The subsequent meta-analysis was carried out using version 5.3 of the RevMan software.Results Twelve reports were found involving a total of 536 patients.The meta-analysis showed significant immediate and short-term effects of extracorporeal shock waves in treating spasticity in the finger flexors,wrist flexors,and biceps brachii after stroke.However,no significant improvement was observed in the treatment of wrist or lower limb spasticity.Conclusion Extracorporeal shock wave therapy can effectively relieve some post-stroke spasticity safely.It can be used as an auxiliary treatment with many patients.

关 键 词：体外冲击波 痉挛 随机对照试验 系统评价 

分 类 号：R74[医药卫生—神经病学与精神病学]