针灸治疗急性脑梗死临床疗效的Meta分析

The effectiveness of acupuncture and moxibustion in treating acute cerebral infarction： A meta-analysis

目的 采Meta分析软件分析针灸对急性脑梗死患者的美国国立卫生研究院脑卒中量表（NIHSS）评分及有效率的影响，从而评价针灸对脑梗死的临床疗效。 方法 检索并选取公开发表的关于针灸治疗急性脑梗死的临床随机对照试验文献，对符合纳入标准的，采用Rev Man5.3版统计学软件进行统计学分析。 结果 本研究共纳入研究39项，患者3792例，经Meta分析发现，神经功能缺损评分MD=-1.86，其95%可信区间为-2.06^-1.66，差异有统计学意义（P〈0.01），结果表明，针灸结合西医常规综合疗法对急性脑梗死患者神经功能缺损的改善效果优于西医常规综合疗法；有效率Meta分析结果，疗效合并效应量OR=3.95，其95%可信区间为3.02~5.16，差异有统计学意义（P〈0.01），结果表明，针灸结合常规西医综合疗法治疗急性脑梗死的有效率优于西医常规综合治疗；显效＋痊愈率Meta分析结果为，疗效合并效应量OR=1.54，其95%可信区间为1.40~1.70，差异有统计学意义（P〈0.01），结果表明，针灸结合常规西医综合疗法治疗急性脑梗死的显效＋痊愈率优于西医常规综合疗法。 结论 针灸治疗急性脑梗死有效。

Objective To analyze the clinical efficacy of acupuncture and moxibustion in treating acute cerebral infarction. Methods A thorough literature search of randomized and controlled tests of acupuncture and moxibustion in treating the acute cerebral infarction was conducted. A meta-analysis was performed using version 5.3 of the ReviewManager software. Results Thirty-nine reports covering 3792 cases were found and analyzed. The neurologic impairment analysis found that in the experimental group mean difference （MD） was -1.86, with the 95% credibility interval （CI） of between -2.06 and -1.66 showing significant differences compared with the control group. The average clinical effectiveness rate of the experimental groups was 3.95, with a 95% CI of between -3.02 and 5.16, significantly higher than the control groups′. The experimental groups′ markedly effective rate was 1.54, with a 95% CI of 1.40 to 1.70, showing significant differences compared with the control groups. Conclusion Acupuncture and moxibustion are effective in treating acute cerebral infarction. They are worth popularizing in clinical practice.