蜡疗治疗儿童痉挛型脑瘫临床疗效的Meta分析

目的 系统评价蜡疗治疗儿童痉挛型脑瘫的疗效,为蜡疗在儿童痉挛型脑瘫治疗中的应用提供依据。方法 计算机检索CMB、CNKI和万方、维普、PubMed、Embase、Cochrane Library,搜集蜡疗治疗儿童痉挛型脑瘫的随机对照试验(RCT),检索时间均为从建库至2019年12月31日。由至少2位评价员按纳入与排除标准进行文献筛查、资料提取和质量评价。统计学分析采用Review Manager 5.3软件进行Meta分析。结果 共有13篇文献符合纳入标准,共1 063例患者,蜡疗组为552例,对照组511例。Meta分析结果:蜡疗组在提高有效率(OR=5.72,95%CI:3.6～9.11,Z=7.36,P＜0.001),改善MAS评分(MD=0.54,95%CI:0.35～0.73,Z=5.57,P＜0.001)、GMFM-88评分(MD=5.46,95%CI:2.84～8.07,Z=4.09,P＜0.001)、关节活动度(MD=10.89,95%CI:3.47～18.3,Z=2.88,P＜0.004)方面均优于对照组。结论 蜡疗能够提高儿童痉挛型脑瘫的临床疗效,改善患儿肌肉痉挛程度、粗大运动功能、关节活动度,是一种有效的治疗痉挛型脑瘫的方法;但在临床应用过程中应严格把握温度。

Meta-analysis of the therapeutic effect of wax therapy for spastic cerebral palsy in children

Objective To systematically evaluate the clinical effect of wax therapy on spastic cerebral palsy in children, in order to provide reference for the treatment of spastic cerebral palsy. Methods Studies on the clinical effect of wax therapy on spastic cerebral palsy published till December 31st, 2019 were systematically searched through CMB, CNKI and Wanfang,VIP,PubMed, Embase and Cochrane Library. Two evaluators performed document screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Meta-analysis was performed by using the Review Manager 5.3 software. Results Totally 13 studies involving1 063 patients were included, with 552 cases in the wax therapy group and 511 cases were in the control group. Meta analysis result showed that the effective rate (OR=5.72, 95%CI: 3.6—9.11, Z=7.36, P＜0.001), MAS score (MD=0.54, 95%CI: 0.35—0.73, Z=5.57, P＜0.001), GMFM-88 score (MD=5.46,95%CI: 2.84—8.07, Z=4.09, P＜0.001), joint mobility (MD=10.89, 95%CI: 3.47—18.3, Z=2.88, P＜0.004) in the wax therapy group were significantly superior to the control group. Conclusions Wax therapy can improve clinical effectiveness, muscle spasm, grossmotor function and joint mobility of children with spastic cerebral palsy, and it is an effective method for treating spastic cerebral palsy. However, temperature should be strictly controlled during wax therapy.