中药熏蒸治疗脑卒中后痉挛性偏瘫有效性及安全性的Meta分析

Meta Analysis of the Efficacy and Safety of Chinese Medicine Fumigation in the Treatment of Spastic Hemiplegia After Stroke

目的:系统性评价中药熏蒸治疗脑卒中后痉挛性偏瘫的有效性及安全性。方法:计算机检索CNKI、Wan Fang Data、CBM、VIP、PubMed、EMbase、The Cochrane Library和Web of Science数据库,获取有关中药熏蒸治疗脑卒中后痉挛性偏瘫的随机对照研究(RCT),检索时间限制为建库至2020年6月。由2名研究者独立筛选文献,提取资料评价后,采用RevMan 5.4软件进行Meta分析。结果:共纳入9个RCT,包括治疗组患者447例和对照组患者446例。分析结果显示:与对照组相比,中药熏蒸能有效治疗促进中风后痉挛性偏瘫患者功能的恢复(RR=1.98,95%CI 1.26~3.10,P<0.01),改善患者的痉挛状态(MD=-0.35,95%CI-0.52~-0.18,P<0.01),提高患者的日常生活能力(MD=6.01,95%CI 0.95~11.06,P<0.05)及生活质量(MD=8.24,95%CI6.52~9.96,P<0.01),改善患者的肢体运动功能,Fugl-meyer评分(MD=6.09,95%CI4.49~7.70,P<0.01)与MAS评分(MD=2.38,95%CI 1.39~3.37,P<0.01)差异均具有统计学意义。结论:研究表明中药熏蒸可提高治疗脑卒中后痉挛性偏瘫的有效性及安全性。

Objective To systematically evaluate the effectiveness and safety of traditional Chinese medicine fumigation in the treatment of spastic hemiplegia after stroke.Methods Computer search of CNKI,Wan Fang Data,CBM,VIP,PubMed,EMbase,The Cochrane Library,and Web of Science databases to collect randomized controlled trials(RCTs)related to the treatment of spastic hemiplegia after stroke with traditional Chinese medicine fumigation.The search time limit is from the construction Library until June 2020.After 2 reviewers independently screened the literature,extracted data and evaluated the risk of bias,the RevMan 5.4 software was used for Meta analysis.Results A total of 9 RCTs were included,including 447 patients in the treatment group and 446 patients in the control group.The analysis results show that compared with the control group,traditional Chinese medicine fumigation can effectively promote the functional recovery of patients with spastic hemiplegia after stroke(RR=1.98,95%CI 1.26~3.10,P<0.01),and improve the patients spasticity(MD=-0.35,95%CI-0.52~-0.18,P<0.01),improve the patient s ability of daily living(MD=6.01,95%CI 0.95~11.06,P<0.05)and quality of life(MD=8.24,95%CI6.52~9.96,P<0.01),and improve the patient s motor function,Fugl-meyer score(MD=6.09,95%CI 4.49~7.70,P<0.01)and MAS score(MD=2.38,95%CI 1.39~3.37,P<0.01)the differences are statistically significant.Conclusion Current evidence shows that traditional Chinese medicine fumigation can improve the effectiveness and safety of treating spastic hemiplegia after stroke.