摘要
目的系统评价头针(Scalp acupuncture,SA)治疗急性脑出血(Intracerebral hemorrhage,ICH)的疗效和安全性。方法从Cochrane Library、Pubmed、Embase中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数据(WANFANG DATA)、维普网(VIP)数据库中检索随机对照试验(Randomized controlled trial,RCT)和半随机对照试验(Quasi-randomized controlled trial,q-RCT),时间截止至2018年5月。用Rev Man 5.3软件对数据进行分析,结果以相对风险和95%置信区间的平均差表示。结果研究共涉及11个试验中的740名患者,包括8个随机对照试验和3个q-RCT。连续性资料显示,SA结合其他治疗的试验组神经功能缺损程度评分优于与其他单纯治疗的对照组,差异有统计学意义[MD=-3.24,95%置信区间(-4.27,-2.22),I2=48%,P<0.00001];SA结合其他治疗的试验组日常生活活动能力评分优于与其他单纯治疗的对照组,差异有统计学意义[MD=11.64,95%置信区间(6.24,17.05),I2=55%,P<0.0001]。二分类资料显示,SA结合其他治疗的试验组神经功能缺损程度评分与其他单纯治疗的对照组比较,差异无统计学意义[OR=8.55,95%置信区间(0.18,400.39),I2=80%,P=0.27];SA结合其他治疗的试验组日常生活活动能力评分优于与其他单纯治疗的对照组,差异有统计学意义[OR=3.78,95%置信区间(2.22,6.45),I2=0%,P<0.00001]。结论考虑到ICH的高死亡率,临床研究应进一步实施严格的RCT设计,并且死亡或复发率应作为主要结果进行报告。
Objective To systematically evaluate the efficacy and safety of scalp acupuncture(SA)in the treatment of acute intracerebral hemorrhage(ICH).Methods Randomized controlled trials(RCT)and quasi-randomized controlled trials(Q-RCTs)were searched from ten databases up to May 2018.The data were analyzed with Rev Man 5.3 software for effect estimate presented as relative risk and mean difference with a 95%confidence interval.Results In this study,740 patients of 11 trials were involved including eight RCTs and three Q-RCTs.Continuous data showed that the neurological impairment score of the test group with SA combined with other treatments was better than that of the control group with other treatments alone,and the difference was statistically significant[MD=-3.24,95%confidence interval(-4.27,-2.22),I2=48%,P<0.00001].The scores of activities of daily living in the trial group with SA combined with other treatments were better than those in the control group with other treatments alone,and the difference was statistically significant[MD=11.64,95%confidence interval(6.24,17.05),I2=55%,P<0.0001].The binary data showed that there was no significant difference in neurological impairment scores between the test group with SA combined with other treatments and the control group with other treatments alone[OR=8.55,95%confidence interval(0.18,400.39),I2=80%,P=0.27].The scores of daily living ability of the test group with SA combined with other treatments were better than those of the control group with other treatments alone,and the difference was statistically significant[OR=3.78,95%confidence interval(2.22,6.45),I2=0%,P<0.00001].Conclusion Considering high mortality of ICH,the further the rigorously designed RCTs are warranted and death or recurrence rate should be reported as primary outcome.
作者
李春日
廉恩呼
白振民
白增华
张志星
Beata Frcova
任路
LI Chunri;Eunho Yeom;BAI Zhenmin;BAI Zhenghua;ZHANG Zhixing;Beata Frcova;REN Lu(Department of Acupuncture and Moxibustion,the Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang 110005,China;International Education College,Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang 110847,China;School of Sports Medicine and Rehabilitation,Beijing Sport University,Beijing 100084,China;School of Acupuncture and Massage,Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang 110847,China;School of Health Sciences,Slovak Medical University,Banska Bystrica 97405,Slovakia;Gradate College,Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang 110847,China)
出处
《中国中医药现代远程教育》
2021年第8期50-54,共5页
Chinese Medicine Modern Distance Education of China
基金
辽宁省高等学校创新团队【No.辽教函[2018]479号】。
关键词
中风
头针
急性脑出血
随机对照试验
神经功能缺损评分
BARTHEL指数
文献研究
stroke
scalp acupuncture
acute intracerebral hemorrhage
randomized controlled trials
neurological deficit scores
Barthel index
document research