电针配合康复训练治疗脑卒中肩手综合征的系统评价与meta分析

目的 荟萃分析评价电针配合康复训练治疗脑卒中肩手综合征的临床效果。方法 由2位研究人员独立进行文献检索,数据库包括PubMed、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国知网、维普和万方数据库,检索主题为电针配合康复训练治疗脑卒中肩手综合征的临床效果；对纳入文献提取数据,进行系统评价与Meta分析。检索策略由第一作者确定,如遇分歧讨论解决或交由第三作者裁定。结果 共纳入23篇文献进行定量,研究性质为随机或半随机对照试验。Meta分析结果显示,治愈率与总有效率的合并效应量相对危险度分别为：1.48(95 %-CI：1.35,1.63),1.15(95 %-CI：1.11,1.19)。临床症状与量表评价方面,各指标合并WMD分别为：FMA(Fugl-Meyer Assessment),7.36(95 %-CI：4.71, 10.02)；MBI(Modified Barthel Index ),16.09(95 %-CI：-7.52, 39.70)；VAS(visual analog scale),-1.54(95 %-CI：-1.86, -1.21)；水肿,-1.39(95 %-CI：-1.81, -0.98)。结论 与康复训练比较,电针配合康复训练可显著提高临床疗效,显著改善上肢运动功能、日常生活活动能力,显著缓解疼痛、水肿,但尚需更多高质量、大样本的随机对照试验,以进一步验证疗效,并进行临床推广应用。

Electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke: a systematic review and meta-analysis

Objective To evaluate the therapeutic effects of electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke. Methods PubMed, EMBASE, cochrane library, China Biology Medicine disc,China National Knowledge Infrastructure, Vip Journal Integration Platform and WanFang Data were searched. Full-text studies on the therapeutic effects of electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke were included. Meta-analysis was utilized with R-3.3.3. Results 22 RCTs and 1 CCT were identified and included in present study. Compared with rehabilitation training, electropuncture plus rehabilitation training was associated with an improved efficacy (RR = 1.48; 95 % CI: 1.35-1.63), significant increases with MDs of 7.36(95 %-CI: 4.71, 10.02) for Fugl-Meyer Assessment(FMA), and 16.09(95 %-CI: -7.52, 39.70) for Modified Barthel Index(MBI), and significant decreases with MDs of -1.54(95 %-CI: -1.86, -1.21) for visual analog scale for pain(VAS), and -1.39(95 %-CI: -1.81, -0.98) for edema. Conclusion Our findings suggested that electropuncture combined with rehabilitation training produced better efficacy in treatment of shoulder-hand syndrome after stroke, and improvements in clinical symptoms, worthy of widely clinical application. However,RCTs with further good quality are required to strengthenSour findings.