系统评价浮针治疗卒中后肩痛的临床疗效

Systematic Reviews of Clinical Effect of Floating Needle in the Treatment of Shoulder Pain after Stroke

目的:采用系统评价方法,探讨浮针治疗卒中后肩痛的临床疗效。方法:检索Cochrane Library、PubMed、Embase、Science online、AMED、中国期刊全文数据库、维普全文数据库、中国生物医学文献数据库、万方数据库等。检索时限设置为建库开始至2019年2月。查找浮针治疗卒中后肩痛的随机/半随机对照试验。由2名评价者独立对纳入研究的文献进行Jadad质量评分并提取数据,采用RevMan5.3、Stata15.0进行系统评价与Meta分析。结果:共纳入18项研究,共计1 405例患者,与对照组比较,浮针治疗组在改善卒中后肩手综合证评估量表评分(Shoulder-hand syndrome scale,SHSS)、疼痛视觉模拟量表评分(Visual analogne scale,VAS)及上肢运动功能量表(Fugl-meyer assessment,FMA)评分上均明显较优(P <0.01)。结论:浮针治疗卒中后肩痛可有效改善患者的上肢功能及疼痛症状,提高生活质量。但基于文献质量普遍偏低,该结论仍需谨慎对待,需更多多中心、大样本、高质量设计的随机对照试验来支持和印证。

Objective:To discuss the clinical effect of floating needle in the treatment of shoulder pain after stroke by systematic reviews.%Methods:Cochrane Library,PubMed,EMabse,Science online,AMED,CNKI,VIP database,China Biology Medicine disc and Wanfang database were searched to collect randomized/semi-randomized controlled trials of floating needle in the treatment of shoulder pain after stroke,the retrieval time being from the database establishment day to February2019.Two evaluators independently scored the Jadad Scale of the included literatures and extracted data,and RevMan5.3 and Stata15.0 were used for systematic evaluation and meta-analysis.Results:A total of 18 studies were included,including 1 405 patients.Compared with the control group,the Shoulder-hand syndrom scale(SHSS),the Visual analogne scale(VAS)and the Fugl-meyer assessment(FMA)score of upper limb in improving shoulder pain after stroke in the floating-needle treatment group were significantly better(P<0.01).Conclusion:Floating needle in treating shoulder pain after stroke can effectively improve the upper limb function and pain symptoms,and improve the quality of life.However,due to the generally low quality of literature,this conclusion still needs to be referred with caution,and it needs more randomized controlled trials with large samples and high quality design to support and verify.