针刺治疗脑卒中后焦虑有效性和安全性的系统评价  

Systematic Evaluation of Efficacy and Safety of Acupuncture in the Treatment of Post-stroke Anxiety

作　　者：王岳青 魏颖 张晋岳 WANG Yueqing;WEI Ying;ZHANG Jinyue(The First Clinical College,Shanxi University of Chinese Medicine,Shanxi Province,Jinzhong 030619,China)

机构地区：[1]山西中医药大学第一临床学院,山西晋中030619

出　　处：《中国中医药现代远程教育》2024年第13期103-106,共4页Chinese Medicine Modern Distance Education of China

摘　　要：目的评估针刺治疗方法对脑卒中后焦虑(Post-stroke anxiety,PSA)患者的临床效果,明确针刺治疗PSA的安全性。方法从国内外多个数据库检索收集针刺及电针治疗PSA的临床随机对照试验,检索时间为建库至今。由2位研究者独立提取数据,3位研究者进行偏倚的风险的评估。结果共纳入10篇文献,针刺组5篇,电针组5篇,涉及患者686例。Meta分析结果显示:针刺治疗组与氟哌噻吨美利曲辛片组相比,在减轻汉密尔顿焦虑量表(HAMA)评分、焦虑自评量表(SAS)评分、Barthel指数(BI)评分方面,差异无统计学意义。电针与选择性5-羟色胺再吸收抑制剂(SSRIs)类药物相比,在减轻HAMA评分方面,差异有统计学意义[均值差(MD)=-0.87,95%置信区间(CI)(-1.67,-0.06),P<0.05];在降低BI评分方面,差异无统计学意义。结论针刺和电针在改善PSA患者的焦虑状态、提高患者日常生活能力方面,效果与西药无明显差异,不良反应的发生率明显低于西药。Objective To evaluate the clinical effect of acupuncture therapy on patients with post-stroke anxiety(PSA),and to deter-mine the safety of acupuncture therapy for PSA.Methods Randomized controlled clinical trials of acupuncture and electroacupunc-ture in the treatment of PSA were collected from many databases at home and abroad,and the search time was since the establishment of the database.Data were extracted independently by two researchers and the risk of bias was assessed by three researchers.Results A total of 10 literatures were included,including 5 in the acupuncture group and 5 in the electroacupuncture group,involving 686 pa-tients.The results of meta-analysis showed that there was no significant difference in reducing Hamilton Anxiety Scale(HAMA)score,self-rating Anxiety Scale(SAS)score and Barthel index(BI)score between the acupuncture treatment group and the halperthixol meli-tracen tablet group.Compared with selective serotonin reuptake inhibitors(SSRIs),electroacupuncture treatment group showed statisti-cally significant difference in reducing HAMA score[mean difference(MD)=-0.87,95%confidence interval(CI)(-1.67,-0.06),P<0.05].There was no significant difference in reducing SAS score and BI score.Conclusion There was no significant difference be-tween acupuncture and electroacupuncture in improving the anxiety state and the ability of daily living in PSA patients,and the inci-dence of adverse reactions was significantly lower than that of Western medicine.

关 键 词：郁病 卒中后焦虑 针刺疗法 META分析 随机对照 

分 类 号：R246.6[医药卫生—针灸推拿学]