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王懿娜,刘小平,包烨华.电针配合康复训练治疗脑卒中肩手综合征的系统评价与meta分析[J].浙江中西医结合杂志,2019,29(11):
电针配合康复训练治疗脑卒中肩手综合征的系统评价与meta分析
Electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke: a systematic review and meta-analysis
投稿时间:2019-06-06  修订日期:2019-10-16
DOI:
中文关键词:  脑卒中  肩手综合征  电针  康复训练  系统评价与Meta分析
英文关键词:
基金项目:
作者单位E-mail
王懿娜* 杭州市中医院 1262239030@qq.com 
刘小平 杭州市中医院针灸康复科  
包烨华 杭州市中医院针灸康复科  
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中文摘要:
      目的 荟萃分析评价电针配合康复训练治疗脑卒中肩手综合征的临床效果。方法 由2位研究人员独立进行文献检索,数据库包括PubMed、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国知网、维普和万方数据库,检索主题为电针配合康复训练治疗脑卒中肩手综合征的临床效果;对纳入文献提取数据,进行系统评价与Meta分析。检索策略由第一作者确定,如遇分歧讨论解决或交由第三作者裁定。结果 共纳入23篇文献进行定量,研究性质为随机或半随机对照试验。Meta分析结果显示,治愈率与总有效率的合并效应量相对危险度分别为:1.48(95 %-CI:1.35,1.63),1.15(95 %-CI:1.11,1.19)。临床症状与量表评价方面,各指标合并WMD分别为:FMA(Fugl-Meyer Assessment),7.36(95 %-CI:4.71, 10.02);MBI(Modified Barthel Index ),16.09(95 %-CI:-7.52, 39.70);VAS(visual analog scale),-1.54(95 %-CI:-1.86, -1.21);水肿,-1.39(95 %-CI:-1.81, -0.98)。结论 与康复训练比较,电针配合康复训练可显著提高临床疗效,显著改善上肢运动功能、日常生活活动能力,显著缓解疼痛、水肿,但尚需更多高质量、大样本的随机对照试验,以进一步验证疗效,并进行临床推广应用。
英文摘要:
      Objective To evaluate the therapeutic effects of electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke. Methods PubMed, EMBASE, cochrane library, China Biology Medicine disc,China National Knowledge Infrastructure, Vip Journal Integration Platform and WanFang Data were searched. Full-text studies on the therapeutic effects of electropuncture plus rehabilitation training for shoulder-hand syndrome after stroke were included. Meta-analysis was utilized with R-3.3.3. Results 22 RCTs and 1 CCT were identified and included in present study. Compared with rehabilitation training, electropuncture plus rehabilitation training was associated with an improved efficacy (RR = 1.48; 95 % CI: 1.35-1.63), significant increases with MDs of 7.36(95 %-CI: 4.71, 10.02) for Fugl-Meyer Assessment(FMA), and 16.09(95 %-CI: -7.52, 39.70) for Modified Barthel Index(MBI), and significant decreases with MDs of -1.54(95 %-CI: -1.86, -1.21) for visual analog scale for pain(VAS), and -1.39(95 %-CI: -1.81, -0.98) for edema. Conclusion Our findings suggested that electropuncture combined with rehabilitation training produced better efficacy in treatment of shoulder-hand syndrome after stroke, and improvements in clinical symptoms, worthy of widely clinical application. However,RCTs with further good quality are required to strengthenSour findings.
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