补阳还五汤联合康复治疗脑卒中后肩手综合征的Meta分析

Meta-analysis of the Effectiveness of Buyang Huanwu Decoction Combined with Rehabilitation for the Treatment of Post-stroke Shoulder and Hand Syndrome

目的系统评价补阳还五汤联合康复治疗对于脑卒中后肩手综合征患者的临床疗效。方法通过中国知网、维普中文科技期刊数据库、中国生物医学文献数据库、万方数据库、PubMed、EMbase全面检索,筛选符合纳入标准的文献,检索时间为建库至2021年6月,采用Revman 5.3进行分析。结果共纳入文献12篇,其中,实验组527例病例,对照组524例病例。Meta结果显示实验组使用补阳还五汤联合康复治疗其总有效率优于单纯进行康复治疗[RR=1.22,95%CI:1.10~1.35,P=0.0002],肩关节疼痛视觉模拟评分[WMD=-3.78,95%CI:-5.06~-2.51,P<0.00001)],Fugl-Meyer运动功能评分[WMD=9.90,95%CI:8.37~11.43,P<0.0001]。结论补阳还五汤联合康复治疗在增加治疗的有效性、减轻患者疼痛、增加肢体运动功能、减少患肢功能障碍、减轻肢体肿胀方面具有较好临床疗效,但仍需要开展更多研究进一步验证。

Objective To systematically evaluate the efficacy of Buyang Huanwu decoction combined with rehabilitation in the treatment of post-stroke shoulder and hand syndrome.Methods A systematic literature searching of CNKI,Wanfang database,VIP,PubMed and EMbase is performed up to the end of Jun 2021.All statistical analysis is performed using the Revman 5.3 software.Results A total of 12 studies including 527 combined treatment patients and 524 rehabilitation are selected.The meta-analysis results show that compared with the control group(rehabilitation),Buyang Huanwu decoction combined with rehabilitation can significantly improve total clinical effective rate of post-stroke shoulder and hand syndrome treatment[RR=1.22,95%CI:1.10~1.35,P=0.0002].The visual analogue score for shoulder pain score of the experimental group is lower than that of the control group[WMD=-3.78,95%CI:-5.06~-2.51,P<0.00001)].The Fugl-Meyer assessment of motor recovery after stroke score of the experimental group is higher than that of the control group[WMD=9.90,95%CI:8.37~11.43,P<0.0001].Conclusion The combined treatment of Buyang Huanwu decoction and rehabilitation has a good clinical effect in increasing the effectiveness of treatment,alleviating patients'pain,increasing limb motor function,reducing the dysfunction of affected limbs and alleviating limb swelling,but it still needs to be further verified by more studies.