中药熏洗治疗中风后偏瘫临床疗效Meta分析

A Meta Analysis of Clinical Effect of Chinese Herbal Fumigation on Hemiplegia After Stroke

目的:评价中药熏洗治疗中风后偏瘫的有效性。方法:用计算机检索中国知网、万方、维普、中国生物医学文献服务系统(CBM)、PubMed及Cochrane Library等数据库,检索时间由各数据库建库至2019年3月20日。严格按照检索方法与纳入、排除标准,由两名研究者独立检索与筛选文献,提取所需资料后采用Cochrane的风险评估标准进行质量评价。运用RevMan5.3软件进行Meta分析。结果:共纳入12个随机对照试验,1 259名患者。Meta分析结果显示:中药熏洗结合西药或康复治疗中风后偏瘫患者的总有效率、肢体运动功能(FMA)评分、Barthel指数(BI)评分、改良Barthel指数(MBI)评分均优于单用西药或康复治疗,差异均有统计学意义(P<0.01)。结论:中药熏洗可提高中风后偏瘫的临床疗效,且优于单用西药或康复治疗。但由于本研究纳入文献的质量受限,样本量较少,故中药熏洗治疗中风后偏瘫的临床疗效仍需更多严谨、高质量、大样本的随机对照试验加以验证。

Objective: To evaluate the curative effect of Chinese herbal fumigation in treating hemiplegia after stroke.Methods: The literature from the day when each database was established to March 20, 2019 from China national knowledge Infrastructure(CNKI), Wanfang Database, VIP Database, China Biology Medicine disc(CBM), PubMed and Cochrane Library were searched. Two researchers separately reviewed and selected literature in strict accordance with the retrieval method,inclusion criteria and exclusion criteria. Then the risk assessment criteria of Cochrane were used for quality evaluation,and a meta analysis was performed via RevMan5.3 software. Results:A total of 12 randomized controlled trials with 1, 259 patients were included. According to the meta analysis, the total effective rate, the score of Fugel-Meyer Assessment(FMA),the score of the Barthel Index(BI) and the modified Barthel Index(MBI) of the therapy of Chinese herbal fumigation combined with western medicine or rehabilitation nursing in treating hemiplegia after stroke were better than those of simple application of western medicine or rehabilitation nursing, differences being significant(P<0.01). Conclusion:Chinese herbal fumigation can improve the clinical effect in treating patients with hemiplegia after stroke,and is better than western medicine alone or rehabilitation nursing. However,due to the limited quality of the literature included in this study and the small-scale sample size,when applying Chinese herbal fumigation,it is required to be cautious and justify it through higher quality and larger-scale randomized controlled trials.