强化训练治疗青少年脑性瘫痪的Meta分析

Meta-analysis of intensive training for adolescents and children with cerebral palsy

目的应用Meta分析评价强化训练治疗脑瘫患儿的作用。方法检索Pub Med、Embase、The Cochrane Library、中文期刊全文数据库(CNKI)、万方数据资源系统(Wanfang Database)、维普(VIP)等数据库中2008年1月-2018年1月关于强化训练治疗脑性瘫痪的随机对照试验文献,根据纳入排除标准,对最终的文献进行归类整理,提取原始有效数据后进行汇总,利用Rev-Man 5.3软件进行Meta分析。结果最终纳入近8年发表的12篇英文研究文献,共452个病例,患儿年龄范围为4.2~18.6岁。强化训练10 d^24周可以使患儿6 min行走距离增长[SMD=0.52,95%CI(-0.11,0.94),P=0.01],但不能改善脑瘫患儿粗大运动功能[SMD=0.11,95%CI(-0.17,0.39),P=0.45],不能提高步行10 m最适步速[SMD=0.45,95%CI(-0.05,0.95),P=0.08]。结论强化训练治疗在改善脑瘫患儿步行功能等方面具有一定效果。

Objective To evaluate the effect of intensive training on patients with cerebral palsy by meta-analysis. Methods We searched paper published from January 2008 to January 2018 through Pub Med, Embase, The Cochrane Library, Chinese Journal Full-text Database（CNKI）, Wanfang Database, VIP databases etc. The literatures were evaluated according to inclusion and exclusion criteria. Then we extracted original data from the included papers and meta-analysis was performed by software Rev-Man 5.3. Results Finally, 12 studies published in English were included, with a total of 452 cases. The age range of children was 4.2 to 18.6 years old. Ten days to 24 weeks of intensive training could increase the walking distance within 6 minutes [SMD=0.52, 95% CI（-0.11, 0.94）, P=0.01], but it could not improve the gross motor function in children with cerebral palsy [SMD=0.11, 95% CI（-0.17, 0.39）, P=0.45] and the walking speed of 10 meters [SMD=0.45, 95% CI（-0.05, 0.95）, P=0.08]. Conclusion Intensive training has a certain effect in improving walking function of adolescents and children with cerebral palsy.