不同针法结合Bobath疗法对脑瘫患儿运动功能及临床疗效恢复的系统评价及Meta分析  

Systematically Evaluation and Meta-analysis of Different Acupuncture Methods Combined with Bobath Therapy on the Recovery of Motor Function and Clinical Efficacy in Children with Cerebral Palsy

作　　者：吕秀英 吴宝贵 贺文娟 王晓倩 石琳[1] LYU Xiuying;WU Baogui;HE Wenjuan;WANG Xiaoqian;SHI Lin(Department of Pediatric Neurorehabilitation,the General Hospital of Ningxia Medical University,First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Ningxia Rehabilitation Medical Center,Ningxia People’s Hospital,Third Clinical Medical College of Ningxia Medical University,Yinchuan 750021,China;Rehabilitation Hospital of the First People’s Hospital of Yinchuan,Second Clinical Medical College of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院儿三科神经康复组,宁夏医科大学第一临床医学院,银川750004 [2]宁夏回族自治区人民医院宁夏康复医学中心,宁夏医科大学第三临床医学院,银川750021 [3]银川市第一人民医院康复医院,宁夏医科大学第二临床医学院,银川750001

出　　处：《宁夏医科大学学报》2023年第12期1228-1237,共10页Journal of Ningxia Medical University

摘　　要：目的系统评价不同针法结合Bobath疗法治疗脑瘫患儿的疗效。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、Medicine、中国生物医学文献数据库、中国知网、万方数据库、读秀学术和重庆维普网站,搜集有关经典针法、头针、体针、温针结合Bobath疗法对脑瘫患儿治疗效果的随机对照试验(RCT),检索时限均为建库至2021年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏移风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入38篇RCT,包括3274例患儿。Meta分析显示,与常规康复治疗相比,不同针法结合Bobath疗法能更有效地改善脑瘫患儿粗大运动功能(MD=0.64,95%CI为0.53~0.75,P<0.001)、增强脑瘫患儿日常生活活动能力(MD=1.59,95%CI为1.23~1.95,P<0.001)、降低脑瘫患儿四肢肌张力(MD=-1.20,95%CI为-1.36~-1.04,P<0.001),联合治疗效果优于单纯常规康复治疗(OR=3.28,95%CI为2.65~4.06,P<0.001)。结论对脑瘫患儿的治疗,针刺联合Bobath疗法优于常规康复治疗。Objective To systematically evaluation of the efficacy of different acupuncture methods combined with Bobath therapy in the treatment of children with cerebral palsy.Methods PubMed,Embase,Web of Science,Cochrane Library,Medicine,China Biomedical Database,CNKI,Wanfang,Duxiu and VIP websites were conducted to collect randomized controlled trial(RCT)on the therapeutic effects of classic acupuncture techniques,scalp acupuncture,body acupuncture,warm acupuncture combined with Bobath therapy on children with cerebral palsy were searched on the internet.The search period was from the establishment of the database until June 2021.After two researchers independently screened the literature,extracted data,and evaluated the risk of bias included in the study,a Meta-analysis was conducted using RevMan 5.3 software.Results A total of 38 RCTs were included,including 3274 children.Meta-analysis revealed that compared with conventional rehabilitation,different acupunctures combined with Bobath therapy were more effective in improving gross motor function in children with cerebral palsy than conventional rehabilitation(MD=0.64,95%CI:0.53-0.75,P<0.001),increasing ability to perform activities of daily living in children with cerebral palsy(MD=1.59,95%CI:1.23-1.95,P<0.001),and reducing extremity muscle tone in children with cerebral palsy(MD=-1.20,95%CI:-1.36--1.04,P<0.001).The combined treatment was superior to conventional rehabilitation alone(OR=3.28,95%CI:2.64-4.06,P<0.001).Conclusion Available evidence suggests that acupuncture combined with Bobath therapy is superior to conventional rehabilitation for children with cerebral palsy.Due to the quality of the included studies and the method of acupuncture point selection,this conclusion needs to be validated by more high-quality studies.

关 键 词：针刺 脑瘫 系统评价 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]