中药熏蒸干预脑卒中后肩手综合征的康复效果系统评价和Meta分析

Systematic Evaluation and Meta-analysis of Rehabilitation Effect of Traditional Chinese Medicine Fumigation on Shoulder-Hand Syndrome after Stroke

目的:系统评价中药熏蒸干预脑卒中后肩手综合征的临床疗效,为中药熏蒸干预脑卒中后肩手综合征提供循证医学依据。方法:计算机检索中英文数据库中关于中药熏蒸干预脑卒中后肩手综合征的临床随机对照试验,并参照Cochrane系统评价手册中的文献质量评价标准对纳入的文献进行质量评价,使用RevMan 5.3进行Meta分析。结果:最终纳入12篇文献,共887例患者。经Meta分析,试验组在疼痛、干预2周FMA[MD=4.16,95%CI(2.90,5.42),Z=6.47,P<0.00001]、干预4周FMA[MD=6.01,95%CI(4.95,7.08),Z=11.07,P<0.00001]及临床疗效[MD=3.11,95%CI(1.48,6.52),Z=3.00,P=0.003<0.05]等方面均优于对照组,差异有统计学意义。结论:现阶段临床随机对照试验表明,中药熏蒸可以缓解患者肢体疼痛,提高上肢运动功能及临床疗效,但由于本系统评价纳入文献的质量较低、研究样本量小,今后还需大样本、多中心的临床随机对照试验加以验证。

Objective:To systematically evaluate the clinical effect of Chinese Herbal Fumigation on shoulder-hand syndrome after stroke,and to provide medical evidence for the intervention of Chinese Herbal Fumigation on shoulder-hand syndrome after stroke.Methods:Randomized controlled clinical trials of Chinese Herbal Fumigation on shoulder-hand syndrome after stroke were retrieved from Chinese and English databases by computer.The quality of the included literatures was evaluated according to the literature quality evaluation criteria in the Cochrane system evaluation manual.RevM an 5.3 was used for meta-analysis.Results:A total of 887 patients were included in 12 literatures.M eta-analysis showed that the experimental group was superior to the control group in terms of pain,two-week intervention in FM A[MD=4.16,95%CI(2.90,5.42),Z=6.47,P<0.00001],four-week intervention in FMA[MD=6.01,95%CI(4.95,7.08),Z=11.07,P<0.00001]and clinical efficacy[MD=3.11,95%CI(1.48,6.52),Z=3.00,P=0.003<0.05].Conclusion:At present,the clinical randomized controlled trials showthat Chinese herbal fumigation can relieve limb pain,improve upper limb motor function and clinical efficacy.However,due to the lowquality of the literature in the research,small number of research samples and so on.The conclusion mentioned above still need larger sample,multi-center clinical randomized controlled trials to verify.