针灸治疗小儿脑瘫的Meta分析

Meta analysis of acupuncture treatment for children with cerebral palsy

目的:探讨针灸治疗小儿脑性瘫痪的临床疗效,为临床实践提供循证医学证据。方法:全面检索CNK(I1989-2012年)、VIP(1989-2012年)、万方(1989-2012年)等数据库,收集针灸治疗小儿脑性瘫痪的临床随机对照试验。经筛选,最终纳入符合标准的12篇文献作为Meta分析对象。用Cochrane协作网免费提供的Review Manage5.0专用软件进行统计分析。结果:12项研究经Meta分析合并,结果显示,12项研究同质性检验结果,χ2=3.12,自由度为11(P=0.99)(P>0.1),表明12项研究具有同质性,故采用固定效应模式进行分析计算、汇总统计量。OR合并后经Z检验:Z=7.11(P<0.00001),说明针灸和其他疗法相比,临床疗效的差异有统计学意义。结论:现有的临床证据表明,针灸治疗脑瘫疗效明显优于单纯康复或药物治疗,但鉴于本研究纳入的方法学质量偏低、样本量有限,尚需要更多设计合理、执行严格的大样本、科学规范的高质量临床随机对照试验来进一步验证其临床疗效。

Objective： To discuss the clinical curative effect of acupuncture treatment of infantile cerebral palsy and provide evidence-based medical evidence for clinical practice. Methods： Comprehensively search CNKI （1989-2012）, VIP （1989-2012）, ten thousand （1989-2012）, such as database, collect clinical randomized controlled trials of acupuncture in the treatment of children with cerebral palsy. After screening, finally included in the standard 12 articles as a Meta analysis object. Using Review Manage5.0 specialized software Cochrane provided free for statistical analysis. Results： 12 researches by Meta analysis combined, the results showed that 12 studies homogeneity test results, Chi square is 3.12, degrees of freedom is 11 （P=0.99） （P〉0.1）, and 12 studies have homogeneity, so use the fixed effects model to analysis ,calculation and summary statistics. OR checked by Z test： Z=7.11 （P〈0.00001）, suggested that acupuncture treatment compared with other treatments, clinical curative effect of the difference has statistical significance. Conclusion： Current clinical evidence suggested that the curative effect of acupuncture treatment of cerebral palsy curative better than simple rehabilitation or medication. But with this research low methodological quality, limited sample size, it needs more large sample of reasonable design, execution, strict, scientific and standardized,high quality clinical randomized controlled trials to further verify its effectiveness.