针灸治疗脑卒中后肩-手综合征上肢功能康复效果的Meta分析  

A Meta-analysis of the effect of acupuncture on upper limb function rehabilitation of shoulder hand syndrome after stroke

作　　者：雷俊芳 马恒芹 汤继芹[1] Lei Junfang;Ma Hengqin;Tang Jiqin(College of Rehabilitation,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250355,China)

机构地区：[1]山东中医药大学康复医学院,山东济南250355

出　　处：《华北理工大学学报（医学版）》2023年第5期397-405,共9页Journal of North China University of Science and Technology：Health Sciences Edition

基　　金：山东省老年医学学会基金(编号:LKJGG2021Z018);山东省卫生健康委员会基金(编号:2018WS205)。

摘　　要：目的评价针灸治疗脑卒中后肩-手综合征患者上肢功能的康复效果。方法检索PubMed、the Cochrane Library、Embase、中国知网、万方、维普和中国生物医学文献服务系统数据库,搜集关于针灸治疗脑卒中后肩-手综合征患者上肢功能障碍的临床随机对照试验研究(RCT)文献,检索时段为建库至2021年9月。筛选文献后,按照Cochrane系统评价手册,由2名评价者对纳入文献进行质量评估并提取数据,对能够进行效应量合并的研究利用Review Manager 5.4.1软件进行Meta分析,其余研究采用描述性分析。结果共纳入13篇RCT,共1139个病例。Meta分析结果显示:针灸联合常规康复训练与常规康复训练相比,在上肢运动功能Fugl-Meyer评分[MD=7.66,95%CI(7.05,8.27),P<0.00001]、上肢视觉模拟评分(VAS)[MD=-1.07,95%CI(-1.25,-0.88),P<0.00001]、治疗有效率[RR=1.28,95%CI(1.19,1.38),P<0.00001]方面具有统计学差异,针灸联合常规康复训练可提高脑卒中后肩手-综合征患者的上肢功能。结论针灸联合常规康复训练对脑卒中后肩-手综合征患者的上肢功能康复有一定效果。Objective To systematically evaluate the rehabilitation effect of acupuncture on upper limb function of patients with shoulder hand syndrome after stroke.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang,VIP and CBM databases were searched to collect clinical randomized controlled trials(RCTS)literature on acupuncture for the treatment of upper limb dysfunction in patients with post-stroke shoulder hand syndrome.The search period was established to September 2021.After literature screening,according to the Cochrane Systematic Review manual,two reviewers were employed to evaluate the quality of the included literature and extract the data.Meta-analysis was performed for the studies that could be combined with effect size using Review Manager 5.4.1 software,and descriptive analysis was used for the rest of the studies.Results A total of 13 RCTS involving 1139 cases were included.Meta-analysis results showed that:Compared with conventional rehabilitation training,acupuncture combined with routine rehabilitation training showed fugl-Meyer score of upper limb motor function[MD=7.66,95%CI(7.05,8.27),P<0.00001],visual analog scale of upper limb(VAS)[MD=-1.07,95%CI(-1.25,-0.88),P<0.00001]and the effective rate[RR=1.28,95%CI(1.19,1.38),P<0.00001],acupuncture combined with routine rehabilitation training can improve the upper limb function of patients with shoulder and hand syndrome after stroke.Conclusion Acupuncture combined with routine rehabilitation training has a certain effect on the rehabilitation of upper limb function in patients with shoulder and hand syndrome after stroke.However,most of the existing studies are randomized controlled trials with small samples.Therefore,it is still necessary to design rigorous large-sample,multi-center,high-quality randomized controlled trials in the future to provide scientific basis for evidence-based studies.

关 键 词：脑卒中 肩-手综合征 针灸 上肢 功能 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]