针灸联合康复训练治疗中风后足内翻的系统评价与Meta分析

Systematic Review and Meta-Analysis of Acupuncture Combined with Rehabilitation Training for Treatment of Post-Stroke Foot Inversion

目的系统评价针刺联合康复训练治疗中风后足内翻的临床疗效。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库自建库起至2023年12月20日期间针灸治疗中风后足内翻的随机对照试验,并通过Review Manager 5.4软件进行Meta分析。结果共纳入文献16篇,包括1183例患者。Meta分析结果显示,针刺联合康复训练患者Fugl-Meyer运动功能评分[n=805,MD=2.96,95%CI(0.07,5.86),P<0.05];下肢临床痉挛指数[n=313,MD=-1.23,95%CI(-1.84,-0.62),P<0.01];日常生活活动量表(ADL)评分[n=380,MD=10.14,95%CI(7.54,12.74),P<0.01];临床总有效率[n=640,RR=1.22,95%CI(1.13,1.31),P<0.01];足内翻角度[n=142,MD=-3.06,95%CI(-3.74,-2.39),P<0.01]均优于单纯康复训练组。结论针刺联合康复训练对于改善中风后足内翻患者Fugl-Meyer运动功能评分、下肢临床痉挛指数、日常生活活动量表评分、提高足内翻临床疗效、改善足内翻角度具有较好地疗效。

Objective A systematic review of the clinical efficacy of acupuncture combined with rehabilitation training for post-stroke foot inversion.Methods Randomized controlled trials on acupuncture treatment for post-stroke foot inversion were retrieved from databases including China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,China Biology Medicine Disc(CBMdisc),PubMed,Cochrane Library,Embase,and Web of Science from their inception to December 20,2023.Meta-analysis was performed using Review Manager 5.4 software.Results A total of 16 studies involving 1183 patients were included.The results of the meta-analysis showed that acupuncture combined with rehabilitation training significantly improved the Fugl-Meyer motor function score(n=805,MD=2.96,95%CI[0.07,5.86],P<0.05),lower limb clinical spasticity index(n=313,MD=-1.23,95%CI[-1.84,-0.62],P<0.01),activities of daily living(ADL)score(n=380,MD=10.14,95%CI[7.54,12.74],P<0.01),total clinical efficacy rate(n=640,RR=1.22,95%CI[1.13,1.31],P<0.01),and foot inversion angle(n=142,MD=-3.06,95%CI[-3.74,-2.39],P<0.01)compared to the rehabilitation training alone group.Conclusion Acupuncture combined with rehabilitation training significantly improves Fugl-Meyer motor function scores,lower limb clinical spasticity index,ADL scores,and clinical efficacy for foot inversion,and reduces the foot inversion angle in post-stroke patients,demonstrating good therapeutic efficacy.