颞三针和挛三针联合康复训练治疗中风后痉挛性偏瘫疗效的Meta分析

Meta-analysis on the Effect of Temporal Three-needle and Spastic Three-needle Combined with Rehabilitation Training in the Treatment of Post-stroke Spastic Hemiplegia

目的:系统评价颞三针和挛三针联合康复训练治疗中风后痉挛性偏瘫的临床疗效。方法:利用计算机检索PubMed、Embase、Cochrane Library、CBM、CNKI、维普期刊数据库和万方数据库等,从建库起到2018年5月,收集有关颞三针和挛三针联合康复训练治疗中风后痉挛性偏瘫的随机对照试验,并且依据Coehrane Handbook推荐的文献质量评价办法对符合纳入标准的文献进行质量评价,应用RevMan5.3软件进行统计学处理。结果:最终纳入8个随机对照试验,总计698例,包括颞三针和挛三针联合康复训练治疗组348例,康复训练组350例。Meta分析结果显示,NDS评分:联合组显著低于康复治疗组(P<0.000 01);FMA评分:联合组显著高于康复治疗组(P<0.000 01);ADL评分:联合组显著高于康复治疗组(P<0.000 01);FCA评分:联合组显著高于康复治疗组(P<0.000 01);CSI评分:联合组显著低于康复治疗组(P<0.000 01)。结论:颞三针和挛三针联合康复训练能有效提高中风后痉挛性偏瘫的疗效,但纳入文献质量不高,需要更多大样本、多中心随机对照试验进一步证实。

Objective:To systematically evaluate the efficacy of temporal three-needle and spastic three-needle combined rehabilitation training in treating post-stroke spastic hemiplegia.Methods:The PubMed,Embase,Cochrane Library,CBM,CNKI,VIP and Wan Fang Data were search for studies published before May 2018,in Order to collect randomized concerning temporal three-needle and spastic three-needle therapy in treating post-stroke spastic hemiplegia.The quality of included references was evaluated according to literatures recommended by Cochrane Handbook.RevMan 5.3software was applied in the statistical treatment.Results:Eight trials involving 698patients were reviewed,including 348patients in the group of temporal three-needle and spastic three-needle therapy and 350patients in the control group.Meta-analysis results showed that the scores of NDS of Combination group were lower than the rehabilitation group(P<0.00001);The scores of FMA of Combination group were higher than the rehabilitation group(P<0.00001).The scores of ADL of Combination group were higher than the rehabilitation group(P<0.00001);The scores of FCA of Combination group were higher than the rehabilitation group(P<0.00001);The scores of CSI of Combination group were lower than the rehabilitation group(P<0.00001).Conclusion:Temporal three-needle and spastic three-needle combined rehabilitation training can improve the treatment efficiency of post-stroke spastic hemiplegia.However,more well-designed and large scale multicenter randomized controlled trials shall be made in the future.