电针辅助治疗对颅脑外伤昏迷患者促醒作用随机对照实验的Meta分析和系统评价  

Meta-analysis and Systematic Review of Randomized Controlled Trials of Electro-acupuncture Assisted Therapy on Wakefulness in Patients with Craniocerebral Traumatic Coma

作　　者：陈之兴 彭永 刘新春[2] 甘露 CHEN Zhixing;PENG Yong;LIU Xinchun;GAN Lu(Hunan University of Chinese Medicine,Hunan Changsha 410208,China;The First Affiliated Hospital of Hunan Traditional Chinese Medical College,Hunan Zhuzhou 412000,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药高等专科学校第一附属医院,湖南株洲412000

出　　处：《中医药临床杂志》2021年第2期289-295,共7页Clinical Journal of Traditional Chinese Medicine

基　　金：湖南省自然科学基金(2018JJ6043);湖南省中医药管理局重点课题(201915);湖南省卫健委课题(B20180815);株洲市科技局课题(20160104);湖南省教育厅课题(14C0879)。

摘　　要：目的:探讨电针辅助治疗对治疗颅脑外伤后昏迷患者的促醒疗效,并分析其选穴规律。方法:利用计算机检索4个中文数据库以及其他英文数据库,检索时间从建库到2019年7月,搜集电针辅助治疗颅脑外伤后昏迷患者的临床随机对照试验。并对所选文献进行质量评价,运用RevMan5.3软件对筛选出的文献进行Meta分析。通过Excel软件对文献进行穴位频次统计,分析选穴特点。结果:最终纳入14篇文献(中文13篇,英文1篇),共有885例患者被纳入研究。分析结果显示电针辅助治疗对脑外伤后昏迷患者的促醒率高于常规治疗,合并RR=1.70,95%CI=[1.47,1.95],P<0.00001;格拉斯哥昏迷评分合并MD=1.61,95%CI=[0.86,2.37],P<0.00001;GCS预后评分合并MD=0.76,95%CI=[0.45,1.07],P<0.00001;频次统计前5位的穴位为水沟、百会、内关、涌泉、三阴交。结论:运用电针辅助治疗对脑外伤昏迷患者有明显的促醒作用,选穴主要以水沟、百会等督脉穴为主,遵循近部取穴与远部取穴相结合的原则,电针以水沟、内关、三阴交配伍邻近穴位为主。但是今后仍需要更多高质量、设计严格、多中心的临床随机对照试验提供可靠的证据。Objective:To investigate the effect of electro-acupuncture as adjunctive therapy on awakening patients with coma after craniocerebral trauma,and to analyze the rule of point selection.Methods:A computer was used to search 4 Chinese databases and other English databases,and the search time was from the establishment of the database to July 2019,to collect clinical randomized controlled trials of electro-acupuncture assisted treatment of patients with coma after traumatic brain injury.The quality of the selected literature was evaluated,and the RevMan5.3 software was used to conduct Meta analysis on the selected literature.The frequency statistics of acupoints in the literature were carried out through Excel software,and the characteristics of acupoint selection were analyzed.Results:14 articles (13 in Chinese and 1 in English) were finally included,and a total of 885 patients were included in the study.The analysis results showed that the awakening rate of adjuvant electro-acupuncture in patients with coma after brain injury was higher than that of conventional treatment,combined with RR=1.70,95%CI=[1.47,1.95],P<0.00001;Glasgow coma score combined with MD=1.61,95 %CI=[0.86,2.37],P<0.00001;GCS prognostic score combined MD=0.76,95%CI=[0.45,1.07],P<0.00001;the top 5 acupoints in frequency statistics are Shuigou,Baihui,Nei Guan,Yongquan,Sanyinjiao.Conclusion:The use of electro-acupuncture as a supplementary treatment has obvious awakening effect on patients with traumatic brain injury and coma.The main points of selection are Shuigou,Baihui and other Du Channel points,and follow the principle of combining proximal and distal acupoints.Electro-acupuncture mainly uses adjacent acupoints in Shuigou,Neiguan and Sanyinjiao.However,more high-quality,rigorously designed,multi-center clinical randomized controlled trials are still needed to provide reliable evidence in the future.

关 键 词：电针 颅脑外伤 昏迷 META分析 频数分析 

分 类 号：R246.6[医药卫生—针灸推拿学]