针灸康复治疗中风失语症临床疗效的Meta分析

The Efficacy of Acupuncture on Treating Aphasia following Stroke:A Meta-analysis

目的用Meta分析的方法评价针灸治疗中风失语症的临床疗效。方法计算机检索从建库至2014年10月检索数据库,如CNKI、万方数据库、VIP、CBM、Pubmed、Science Direct等检索数据库。检索针灸治疗中风失语症的随机对照研究,并由两名评价员独立提取需要的文献资料。结果共检索出文献709篇,符合纳入标准的11篇,获得病例数729例,对其进行了Meta分析。Meta分析显示针灸配合语言康复训练与单纯语言康复训练比较,总有效率具有统计学意义,[RR=1.21,95%CI=(1.12,1.31),P<0.00001],提示针灸配合语言康复训练治疗中风后失语疗效优于单纯语言康复训练;单纯针灸治疗与单纯语言训练进行了比较,95%CI线条横线在无效竖线右侧,具有统计学意义,说明单纯针刺治疗优于单纯语言训练组;单纯针灸治疗与单纯西药组比较,95%CI线条横线在无效竖线右侧,具有统计学意义,说明单纯针刺治疗优于单纯西药组;针灸结合中药与单纯中药组比较,95%CI线条横线在无效竖线右侧,具有统计学意义,说明针灸结合中药优于单纯中药组。结论针灸配合语言康复训练是一种有效的治疗手段,但由于本次研究的文献均为小样本,且高偏倚风险的原始文献,因此建议今后开展大样本量、文献质量高的临床试验进行评价。

Objective To evaluate the efficacy of acupuncture treating aphasia following stroke with Meta-analysis.Methods From the beginning date of database to September 2014,randomized controlled trials of acupuncture treating aphasia following stroke from the CNKI database,Wan fang database,VIP database,CBM database,Pubmed database and Science Direct database were collected.All literauture were selected by two investigators independently.Results 709 pieces of literature were searched,among them eleven randomized controlled trials involving 729 patients were chosen and included in the Meta-analysis.The Meta-analysis showed the acupuncture combined rehabilitation was better than only rehabilitation for aphasia following stroke.There was statistical significance in total effective rate [RR=1.21,95%CI=（1.12,1.31）,P〈0.00001];The acupuncture was better than only rehabilitation for aphasia following stroke with invalid 95%CI horizontal line in the vertical bar on the right side.The acupuncture was better than western medicine for aphasia following stroke with invalid 95%CI horizontal line in the vertical bar on the right side.The acupuncture combined Chinese traditional medicine was better than only Chinese traditional medicine for aphasia following stroke with invalid 95% CI horizontal line in the vertical bar on the right side.Conclusion The acupuncture combined rehabilitation is an effective treatment method.But because small samples and high risk of deviation,adequate samples and strict clinical trials must be carried out.