针刺治疗脑梗死非急性期神经功能缺损程度的Meta分析
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作者单位:

1. 广州中医药大学第一附属医院,广东 广州 510405;2. 广州中医药大学,广东 广州 510006;3. 广州市中医院针灸科,广东 广州 510130

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R246.6

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* 基金项目: 广州市科技计划项目(201508020002) 收稿日期: 2016 - 04 - 16 作者简介: 林国华(1964-),男,广东广州人,教授,博士生导师,研究方向:针灸治疗中风、痛症及内科疾病。△通信作者:李丽霞,E-mail:llxia701@126.com


Effectiveness of Acupuncture and Rehabilitation for Treating Neurological Function Deficit Degreeof Non-acute Stage Stroke:A Meta-analysis
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Affiliation:

1. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China;2. Guangzhou University of Chinese Medicine, Guangzhou 510006, China;3. Department of Acupuncture, Guangzhou Hospital of Chinese Medicine, Guangzhou 51

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    摘要:

    目的系统评价针刺结合康复对脑梗死非急性期神经功能缺损程度的有效性。方法计算机检索The Cochrane Library、PubMed、EMbase、MEDLINE、中国生物医学期刊(CBM)、维普(VIP)、中国知网(CNKI)和万方数据库,搜集使用针刺结合康复或单纯针刺治疗脑梗死的相关随机对照试验(RCT)。同时,追溯纳入研究的参考文献,以补充获取相关文献。检索时限均为从建库至2016年1月30日。由2位研究者独立进行文献筛选、资料提取,并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。 结果最终纳入6个RCT,共572例患者。Meta分析结果显示:在改善患者神经功能缺损方面,针刺明显优于康复治疗,且差异有统计学意义,森林图提示MD=-1.39,95%CI(-1.56,-1.22),P<0.00001,I 2 =98%. 结论针刺是一种有效的改善脑梗死非急性期患者神经功能缺损程度的治疗手段,与康复等措施联用,可明显提高治疗效果。但由于纳入本研究的RCT质量数量有限,存在一定的偏倚风险,本研究结论尚需进行更多高质量的临床随机试验进行进一步验证。

    Abstract:

    Objective To systematically review the effectiveness of acupuncture and rehabilitation for treating neurological function defect degree of non-acute stage stroke. Methods Computer retrieval of The Cochrane Library, PubMed, EMbase, MEDLINE, Chinese biomedical journals(CBM), VIP(VIP), China hownet database (CNKI) and ten thousand database, collecting randomized controlled trial(RCT) used acupuncture combining with rehabilitation or simple acupuncture treatment of stroke. At the same time, backing into the research references, and to supplement the access to relevant literature. Retrieval time limit are built from the library until January 30, 2016. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 6 studies involving 572 patients were included. The results of meta-analysis showed that:In terms of improving stroke patients with Neurological Deficit Scale(NDS), There was statistically significant difference between acupuncture and rehabilitation treatment, the forest figure tip:[MD=-1.39, 95%CI(-1.56, -1.22), P<0. 00001, I 2 =98%]. Conclusion Acupuncture are effective therapy methods to improve neurological deficit degree of non-acute stage stroke patients. They can obviously improve the effect of treatment when combined with rehabilitation. However, since the quality and quantity of included studies RCT is limited, and there is a greater risk of sampling bias, selection bias and research bias, the strength of evidence is low. More rigorous studies are needed to verify the above conclusion.

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