Qi Ying-zhou, Fu Li-xin, Xiong Jun, Wang Zai-ling, Mou Jiao, Lu Yin-ming
Tianjin University of TCM, Tianjin, China.
Zhongguo Zhen Jiu. 2009 Aug;29(8):683-8.
To evaluate the effects of acupuncture on post-stroke spastic paralysis.
A systematic evaluation including all the relavant randomized controlled trials (RCTs) or quasi-RCTs of acupuncture and moxibustion for treatment of post-stroke spastic paralysis were carried out according to the method recommended by the Cochrane Collaboration.
Nine hundred and seventy-eight patients being included in fourteen papers met the enrolled criteria. However, their methodological quality was relatively poor. Meta-analysis of nine trials indicated that there was no significant difference between the treatment groups and the control groups in Ashworth scores, Carr-Shepherd scores, nerve defect scores and hip adductor tension scores. Whereas the Fugel-Meyer scores in one trial and the Barthel scores in three trials were better in the treatment groups than those of the control group.
A reliable conclusion can not be drawn from the present data because of the defects in methodological quality and insufficient numbers of trials, especially lack the long-term terminal outcomes, although it appears a tedency that acupuncture can improve the conditions of post-stroke spastic paralysis. Therefore, it is necessary to perform more multi-central RCTs of high quality in future.
评估针刺对脑卒中后痉挛性瘫痪的影响。
按照Cochrane协作网推荐的方法，对所有针刺及艾灸治疗脑卒中后痉挛性瘫痪的相关随机对照试验（RCT）或半随机对照试验进行系统评价。
14篇论文纳入的978例患者符合纳入标准。然而，其方法学质量相对较差。9项试验的Meta分析表明，治疗组与对照组在Ashworth评分、Carr-Shepherd评分、神经缺损评分及髋内收肌张力评分方面无显著差异。而1项试验中的Fugel-Meyer评分及3项试验中的Barthel评分，治疗组优于对照组。
由于方法学质量存在缺陷且试验数量不足，尤其是缺乏长期结局指标，目前的数据尚不能得出可靠结论，尽管针刺似乎有改善脑卒中后痉挛性瘫痪状况的趋势。因此，未来有必要开展更多高质量的多中心随机对照试验。
