从循证医学角度分析推拿治疗中风后痉挛性偏瘫的疗效

Analysis of Massage Cunative Effect for the Treatment of Spastic Hemiplegia after stroke from the Perspectives of Evidence-based Medicine

目的:探讨推拿治疗中风后痉挛性偏瘫的临床疗效,为推拿的临床应用提供循证医学依据。方法:采用cochrane系统评价方法,计算机检索Pubmed、CCTR、CNKI、VIP、万方等数据库并辅以手工检索,收集推拿治疗中风后痉挛性偏瘫的临床随机对照试验和半随机对照试验,采用Rev Man5.2软件统计分析数据。结果:共16项研究总计1098例患者纳入本研究,其中Fugl-Meyer评分中有7个亚组、Ashworth评分和NDS评分各有4个亚组、Barthel指数评分有3个亚组、CSI量表有1个亚组,均显示治疗组优于对照组。结论:据目前临床证据表明,推拿治疗中风后痉挛性偏瘫有效,但本评价所纳入的研究质量不高,仍期待高质量的临床试验提供更有力的证据。

Objective：To discuss the clinical curative effect of massage on post-stroke spastic hemiplegia and provide evidence-based medical evidence for clinical practice. Methods： All of the included articles were retrieved from the PubMed, the Cochrane Library, the CNKI, Chongqing VIP and Wan Fang databases, as well as hand searched relevant journals according to the method recommended by the Cochrane Collaboration. All data were analyzed using Revman 5.2 software. Result：Sixteen studies, total of 1098 cases were enrolled. Whereas the Fugl-Meyer scores of 7 subgroups, the Ashworth and the NDS scores of 4 subgroups, the Barthel scores of 3 subgroups and the CSI scores of one subgroup were better in the treatment group than those of the control group. Conclusion： Current clinical evidence suggested that massage can improve the conditions of post-stroke spastic hemiplegia. But the quality of inclusive literature is low. Therefore, more RCTs of high methodological quality is requested to be carried out.