穴位埋线治疗心脾两虚型失眠有效性与安全性的Meta分析

目的 客观评价穴位埋线治疗心脾两虚型失眠的有效性与安全性。方法 检索Pub Med、中国生物医学文献光盘数据库(CBM)、荷兰医学文摘数据库(Embase)、The Cochrane Library、中国期刊全文数据库(CNKI)、重庆维普数据库(VIP)、万方资源数据库(Wan Fang Data)创库至2022年9月所有穴位埋线治疗本病的随机对照试验(RCT)资料文献,并运用Cochrane风险偏倚工具对文献资料进行证据质量评价,运用Rev Man 5.3软件对数据进行Meta统计分析。结果 最终纳入16例RCT,总共1 055例患者,Meta分析结果显示:临床疗效结果表明穴位埋线组较对照组临床疗效好[OR=4.70,95%CI(3.21,6.88),P<0.000 01];匹兹堡睡眠质量指数(PSQI)评分结果显示穴位埋线法较使用其他方法在降低PSQI评分方面具有优势[MD=-2.46,95%CI(-3.23,-1.69),P <0.000 01];中医证候积分总分结果显示穴位埋线组较对照组在中医证候群评分均有明显降低作用[MD=-2.69,95%CI(-3.82,-1.56),P<0.000 01]。结论 穴位埋线可改善心脾两虚型失眠,调整睡眠形态,改善睡眠质量。

脑卒中并发便秘危险因素的Meta分析

目的:分析脑卒中并发便秘的危险因素,为卒中后便秘的早期预防提供参考依据。方法:计算机检索数据库(中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Science、The Cochrane Library),搜集国内外与卒中后便秘危险因素相关的文献至2021年5月1日。两名研究者独立筛选文献、提取资料、评价偏倚风险,选择RevMan5.4进行Meta分析。结果:纳入13项研究,共2812例,病例组1292例,对照组1520例。Meta分析结果:年龄(OR 1.35,95%CI[1.17,1.55],P<0.001)、女性(OR 3.77,95%CI[2.48,5.73],P<0.001)、卒中类型(出血性脑卒中)(OR 2.87,95%CI[1.94,4.25],P<0.001)、卒中病变部位(基底节病变部位)(OR 4.15,95%CI[1.61,10.71],P<0.001)、排便环境(隐蔽环境)(OR 2.36,95%CI[1.69,3.28],P<0.001)、应用抗抑郁药(OR 3.66,95%CI[1.68,7.96],P=0.001)与脑卒中后便秘有关,糖尿病(OR 1.55,95%CI[0.79,3.05],P=0.20)、BI(Barthel指数)(OR 1.00,95%CI[0.95,1.04],P=0.87)与脑卒中后便秘无关。结论:年龄、性别(女性)、卒中类型(出血性脑卒中)、卒中病变部位(基底节病变部位)、排便隐蔽环境可能是脑卒中并发便秘的危险因素;由于纳入研究数量有限,上述结论仍需更多高质量研究予以验证。

Evaluation of the Curative Effect of "Xingnao Kaiqiao" Acupuncture Based on Brunnstrom Staging on Upper Limb and Hand Motor Function in the Recovery Period after Stroke

Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.

Evaluation on Efficacy of Acupuncture with Cognitive Intervention on Motor Function and Activities of Daily Living in Patients with Stroke

Objective:To observe clinical efficacy of acupuncture with cognitive training on motor function and activities of daily living(ADL)after ischemic stroke.Methods:A total of 68 patients with ischemic stroke in departments of neurology and rehabilitation medicine in Binzhou City People's Hospital of Shandong province from January 2015 to December 2019 were selected.They were randomly divided into the treatment group and the control group,with 34 cases in each group.The 2 groups were both given conventional medication and rehabilitation.The control group received cognitive training,while the treatment group was treated by acupuncture more.Fugl-Meyer Assessment Upper Extremity Scale(FMA-UE),Fugl-Meyer Assessment Lower Extremity Scale(FMA-LE),Modified Barthel Index(MBI)and Mini-mental State Examination(MMSE)were used to evaluate efficacy in the 2 groups respectively before the treatment,2 months and 4 months after the treatment.Results:There was no statistically significant differences in FMA-UE,FMA-LE,MBI and MMSE scores between the 2 groups before the treatment(P>0.05).The scores of FMA-UE,FMA-LE,MBI and MMSE in the 2 groups were significantly improved 2 months and 4 months after the treatment(P<0.05).The efficacy in the treatment group was better than that in the control group.Conclusion:Acupuncture with cognitive training is beneficial to recovery of motor function and improvement of ADL after stroke.At the same time,it also confirms effectiveness of acupuncture on cognitive disorder.