早期干预对脑瘫患儿继发髋关节疾病影响的网状Meta分析  

Effects of Different Interventions on Hip Dysplasia Secondary to Cerebral Palsy in Children:A Network Meta-analysis

作　　者：李园 翟睿 张艺璇 任敬佩 韩露 刘远欧 王俊宏[1] LI Yuan;ZHAI Rui;ZHANG Yi-xuan;REN Jing-pei;HAN Lu;LIU Yuan-ou;WANG Jun-hong(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《世界中西医结合杂志》2024年第3期495-501,共7页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的评价早期预防脑瘫患儿继发髋关节发育不良疗法的有效性。方法检索CNKI、万方、VIP、CBM、PubMed、Embase、Web of Science和Cochrane Library数据库,收集从建库至2022年4月发表的有关预防脑瘫髋关节发育异常疗法的RCT。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件和ADDIS 1.16.8软件进行贝叶斯网状Meta分析。结果最终纳入21个RCT,共包括1228例脑瘫患儿。网状Meta分析表明:(1)常规康复治疗联合家庭髋关节姿势管理、肌肉电刺激、穴位埋线、WBV,分别在改善MP值、内收肌肌张力、GMFM-E区评分、髋关节ROM评价方面疗效最佳;(2)在改善腘绳肌肌张力的评价中,常规康复治疗+靳三针头针+体针治疗效果明显优于常规康复治疗。结论家庭髋关节姿势管理在改善MP值方面临床前景最好,针灸联合常规康复治疗在改善肌张力方面疗效明确。Objective To evaluate the efficacy of different interventions in the prevention of hip dysplasia secondary to cerebral palsy in children.Methods The randomized controlled trials(RCTs)about the interventions in hip dysplasia secondary to cerebral palsy were retrieved from China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP,China Biology Medicine(CBM),PubMed,Embase,Web of Science,and Cochrane Library with the time interval from inception to April 2022.Two evaluators independently screened the articles,extracted the data,and evaluated the bias risk of the studies included.Stata 16.0 and ADDIS 1.16.8 were used for Bayesian network meta-analysis.Results A total of 21 RCTs involving 1228 children with cerebral palsy were included.The network meta-analysis revealed the following results.(1)Conventional rehabilitation therapy combined with home-based hip joint posture management,electrical muscle stimulation,catgut embedment in acupoint,and whole-body vibration(WBV)showed the best efficacy in improving the muscle potential(MP),muscle tension of adductor,gross motor function measure-expanded(GMFM-E)score,and range of motion(ROM)of hip joint,respectively.(2)In terms of improving hamstring muscle tension,conventional rehabilitation therapy+Jin′s acupuncture at three acupoints on the head+body acupuncture outperformed conventional rehabilitation therapy.Conclusion Home-based hip joint posture management has the best clinical prospect in improving the MP,and acupuncture combined with conventional rehabilitation therapy demonstrates definite efficacy in improving muscle tension.

关 键 词：脑瘫 髋关节 随机对照试验 网状Meta分析 

分 类 号：R742[医药卫生—神经病学与精神病学] R684[医药卫生—临床医学]