Vados Larissa, Ferreira Alberto, Zhao ShouFa, Vercelino Rafael, Wang Shu
Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Laboratory of Pharmacology of Pain & Neuromodulation, Instituto de Ciências Básicas da Saúde-ICBS, Universidade Federal do Rio Grande do Sul-UFRGS, Porto Alegre, Brasil.
Acupunct Med. 2015 Jun;33(3):180-7. doi: 10.1136/acupmed-2014-010705. Epub 2015 Mar 31.
To determine whether the combination of acupuncture and rehabilitation produces better results in the treatment of acute or subacute stroke sequelae than rehabilitation alone.
A systematic review was carried out. A search was conducted in March 2014 using PubMed, Medline, the Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI) and Wanfang databases. English and Chinese language articles published within 10 years of the search were reviewed for inclusion. Randomised control trials comparing combined treatment with acupuncture and rehabilitation and rehabilitation alone in patients with acute or subacute stroke (onset until 3 months after stroke) were included in this review. Three review authors independently checked the titles and abstracts of trials for inclusion based on selection criteria. Studies measuring changes of motor function, activities of daily living, neurological deficit or spasticity/range of motion during the treatment period and at the end of follow-up were included.
17 trials met the inclusion criteria, of which five were of good quality. 14 trials had results favourable to acupuncture combined with rehabilitation, compared with conventional rehabilitation treatment alone.
Acupuncture in combination with rehabilitation may have benefits for the treatment of acute and subacute stroke sequelae in comparison with rehabilitation alone. However, many of the studies were at risk of bias. Future studies should focus on reaching a consensus about the most appropriate modality of acupuncture intervention, and the appropriate length of treatment for both interventions, to maximise the potential synergistic outcomes.
确定针灸与康复相结合在治疗急性或亚急性中风后遗症方面是否比单纯康复治疗效果更好。
进行了一项系统评价。2014年3月使用PubMed、Medline、Cochrane图书馆、中国知网数据库（CNKI）和万方数据库进行了检索。对检索10年内发表的英文和中文文章进行纳入审查。本评价纳入了比较针灸与康复联合治疗和单纯康复治疗急性或亚急性中风患者（中风发作至中风后3个月）的随机对照试验。三位评价作者根据选择标准独立检查试验的标题和摘要以确定是否纳入。纳入了测量治疗期间和随访结束时运动功能、日常生活活动、神经功能缺损或痉挛/活动范围变化的研究。
17项试验符合纳入标准，其中5项质量良好。与单纯传统康复治疗相比，14项试验的结果有利于针灸联合康复治疗。
与单纯康复治疗相比，针灸联合康复治疗可能对急性和亚急性中风后遗症的治疗有益。然而，许多研究存在偏倚风险。未来的研究应集中于就最合适的针灸干预方式以及两种干预的适当治疗时长达成共识，以最大化潜在的协同效果。
