针灸治疗脑瘫所致语言障碍的疗效和安全性:系统评价与Meta分析  

Efficacy and safety of acupuncture-moxibustion for cerebral palsy-induced speech impairment:a systematic review and meta-analysis

作　　者：王佳慧 周陶成 鲍超 李建兵 隋宇航 WANG Jiahui;ZHOU Taocheng;BAO Chao;LI Jianbing;SUI Yuhang(The Children’s Hospital of Anhui Province,Hefei 230022,China;Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing 210000,China;The First Clinical Medical College of Nanjing University of Traditional Chinese Medicine,Nanjing 210000,China)

机构地区：[1]The Children’s Hospital of Anhui Province,Hefei 230022,China [2]Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing 210000,China [3]The First Clinical Medical College of Nanjing University of Traditional Chinese Medicine,Nanjing 210000,China

出　　处：《Journal of Acupuncture and Tuina Science》2023年第3期229-238,共10页针灸推拿医学（英文版）

基　　金：全国名老中医专家传承工作室建设项目,No.2016-42;江苏省科技厅社会发展面上项目,No.BE2017769;南京中医药大学自然科学基金,No.XZR2021002;江苏省研究生培养创新工程研究生科研与实践创新计划,No.SJCX21_0771.

摘　　要：目的:评估针灸治疗脑瘫语言障碍的有效性和安全性。方法:2000年1月7日至2021年1月12日通过对7个电子数据库的综合文献检索,评估针灸结合康复训练对脑瘫患儿言语障碍疗效的随机对照试验(RCTs)。纳入试验的质量评估根据Cochrane Reviewers’Handbook的指导进行,使用RevMan 5.3软件进行统计分析。结果:本研究共纳入17项RCTs,涵盖1238名患者。与单独的康复训练相比,针灸结合康复训练对脑瘫患儿言语障碍有显著改善。在治疗言语障碍的穴位中,最常用的有百会、语言区、智三针(神庭和双侧本神)、颞三针(耳尖直上2.0寸为颞Ⅰ针,在第一针前后各旁开1.0寸为颞Ⅱ针和颞Ⅲ针)、四神针(百会穴前后左右各旁开1.5寸)。结论:针灸对儿童接受性、表达性语言的发展以及发育商有更好的疗效。针刺结合康复训练不仅疗效优于对照治疗,而且安全可靠。治疗言语障碍最常用的腧穴为百会、语言区、智三针、颞三针和四神针。Objective:To evaluate the efficacy and safety of acupuncture-moxibustion in the treatment of cerebral palsy-related speech impairment.Methods:A systematic literature search of 7 electronic databases was conducted between January 7,2000 and January 12,2021 to find randomized controlled trials(RCTs)examining the benefits of acupuncture-moxibustion combined with rehabilitation training to cerebral palsy-induced speech impairment.The included trials’quality was assessed using the Cochrane Reviewers’Handbook as a guide,and statistical analysis was carried out using the RevMan 5.3 software.Results:A total of 17 RCTs with 1238 subjects were finally recruited and analyzed.When acupuncture-moxibustion was combined with rehabilitation training,the results showed a considerable improvement in speech impairment compared with the rehabilitation training alone.The most commonly used points for the treatment of speech disorders are Baihui(GV20),Speech Area,Zhisanzhen[Shenting(GV24)and bilateral Benshen(GB13)],Niesanzhen[2 Cun above the ear tip as the first point,with 1.0 Cun anterior and posterior to the current point as the second and third points],and Sishenzhen[1.5 Cun anterior,posterior,and bilateral to Baihui(GV20)].Conclusion:Acupuncture-moxibustion has a stronger effect on children’s development of receptive and expressive language,as well as the developmental quotient.Acupuncture-moxibustion in combination with rehabilitation training is not only more successful than the control treatment,but also safer and more dependable.Baihui(GV20),Speech Area,Zhisanzhen,Niesanzhen,and Sishenzhen are the most widely used points for speech impediment.

关 键 词：针灸疗法 头针刺激区 脑性瘫痪 语言障碍 随机对照试验 META分析 系统评价 

分 类 号：R246.6[医药卫生—针灸推拿学]