电针治疗脑卒中后痉挛性瘫痪系统评价

目的:系统评价电针治疗脑卒中后痉挛性瘫痪的临床疗效。方法:检索中国期刊全文数据库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(重庆维普)、中国生物医学文献服务系统SinoMed、PubMed、Cochrane Library、Web of Science数据库建库至2020年3月关于电针治疗脑卒中后痉挛性瘫痪的中、英文文献。2名研究员对检出文献进行整理,依据Cochrane协作网偏倚风险评价工具进行偏倚风险评估,选用RevMan5.3软件进行Meta分析。结果:最终纳入11篇文献,共879例患者。Meta分析结果提示,有效率评定电针组疗效优于对照组RR=1.27,95%CI1.16,1.40];改良的Ashworth量表(MAS)评定电针组疗效优于对照组MD=-0.36,95%CI-0.57,-0.16];简式Fugl-Meyer评分法(FMA)评定电针组疗效优于对照组MD=10.55,95%CI8.76,12.34];改良Barthel指数(MBI)评定电针组疗效优于对照组MD=6.85,95%CI5.16,8.53];神经功能缺损程度评分(NDS)评定电针组疗效优于对照组MD=-2.61,95%CI-3.01,-2.20];临床痉挛指数(CSI)评定电针组优于对照组MD=-1.11,95%CI-1.60,-0.62],差异均具有统计学意义。结论:电针对于脑卒中后痉挛性瘫痪有一定疗效,鉴于纳入的文献数量较少、质量较低,仍需更多高质量的研究,为临床循证提供依据。

Systematic review and meta-analysis of electro-acupuncture therapy for spastic paralysis after stroke

Objective:To systematically evaluate the clinical efficacy of electroacupuncture in the treatment of spastic paralysis after stroke.Methods:Search the Chinese Journal Full-text Database (CNKI),China Academic Journal Database (Wanfang Data),Chinese Science and Technology Journal Database (Chongqing Weipu),China Biomedical Literature Service System SinoMed,PubMed,Cochrane Library,Web of Science database to Chinese and English literature on electroacupuncture treatment of spastic paralysis after stroke in March 2020.Two researchers sorted out the detected literature,assessed the risk of bias based on the Cochrane Collaboration bias risk assessment tool,and selected RevMan5.3 software for meta-analysis.Results:11 articles were finally included,with a total of 879 patients.Meta analysis results indicate that the effective rate of the electroacupuncture group is better than the control group,RR=1.27,95%CI1.16,1.40];the modified Ashworth scale (MAS) is better than the control group for the curative effect MD=-0.36,95% CI-0.57,-0.16];the simple Fugl-Meyer scoring method (FMA) evaluates that the electroacupuncture group is better than the control group MD=10.55,95% CI8.76,12.34];modified Barthel index (MBI) The curative effect of the electroacupuncture group is better than the control group MD=6.85,95%CI5.16,8.53];the neurological deficit score (NDS) is better than the control group MD=-2.61,95%CI-3.01,-2.20];The clinical spasticity index (CSI) assessment of the electroacupuncture group is better than the control group MD=-1.11,95%CI-1.60,-0.62],the difference is statistically significant.Conclusion:Electroacupuncture has a certain effect on spastic paralysis after stroke.In view of the small number and low quality of the included literature,more high-quality studies are still needed to provide evidence for clinical evidence.