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[针灸对中风后患者痉挛的疗效。系统评价]

[Effectiveness of acupuncture in spasticity of the post-stroke patient. Systematic review].

作者信息

Rodríguez-Mansilla Juan, Espejo-Antúnez Luis, Bustamante-López Ana Isabel

机构信息

Departamento de Terapéutica Médico-Quirúrgica, Facultad de Medicina, Universidad de Extremadura, Badajoz, España.

Departamento de Terapéutica Médico-Quirúrgica, Facultad de Medicina, Universidad de Extremadura, Badajoz, España.

出版信息

Aten Primaria. 2016 Apr;48(4):226-34. doi: 10.1016/j.aprim.2015.05.004. Epub 2015 Jul 10.

Abstract

OBJECTIVE

To determine the effectiveness of acupuncture for reducing spasticity in post-stroke patients.

DESIGN

Literature review.

DATA SOURCE

The literature search was performed using scientific databases from January 2000 to January 2013.

SELECTION OF STUDIES

Out of the 110 studies that were found, nine random and controlled trials were included. Inclusion criteria were based on clinical trials in which participants were over 18 years old, who were suffering with post-stroke spasticity, and one of the experimental groups was treated with acupuncture.

DATA EXTRACTION

The variables were the passive resistance to stretching of the affected limb, and the degree of personal dependence. The variables were assessed by the Modified Ashworth Scale and Barthel Index.

METHODS

The search was performed in the PUBMED, COCHRANE Library, PEDro, Dialnet, CSIC, CINAHL, databases. Search terms included the combination of keywords "acupuncture"; "muscle spasticity"; "stroke".

RESULTS

Passive resistance to stretching, the degree of personal dependence, and motor function of the affected limb showed statistically significant improvements in at least one study included; however, these improvements are not clinically relevant changes. Passive resistance improved in the elbow, ankle, knee, and wrist. An increased joint range was observed, except for the elbow, forearm, and thumb. Improved of the patient dependency was also observed.

CONCLUSIONS

Although improvements relative to the reduction of spasticity are shown, the results have failed to demonstrate the effectiveness of the technique for this ailment. It would take a greater number of studies to calculate the size of the reported effects with homogeneous procedures in the design as well as in the duration, frequency, and measurement tools.

摘要

目的

确定针刺疗法对降低中风后患者痉挛状态的有效性。

设计

文献综述。

数据来源

使用科学数据库进行文献检索,检索时间范围为2000年1月至2013年1月。

研究选择

在检索到的110项研究中,纳入了9项随机对照试验。纳入标准基于临床试验,参与者年龄超过18岁,患有中风后痉挛状态,且其中一个实验组接受针刺治疗。

数据提取

变量为患侧肢体的被动拉伸阻力和个人依赖程度。变量通过改良Ashworth量表和Barthel指数进行评估。

方法

在PUBMED、COCHRANE图书馆、PEDro、Dialnet、CSIC、CINAHL数据库中进行检索。检索词包括关键词“针刺疗法”、“肌肉痉挛”、“中风”的组合。

结果

在至少一项纳入研究中,患侧肢体的被动拉伸阻力、个人依赖程度和运动功能显示出统计学上的显著改善;然而,这些改善并非具有临床意义的变化。肘部、踝部、膝部和腕部的被动阻力有所改善。除肘部、前臂和拇指外,观察到关节活动范围增加。患者的依赖程度也有所改善。

结论

尽管显示出相对于痉挛状态减轻的改善,但结果未能证明该技术对这种疾病的有效性。需要更多的研究,以在设计以及持续时间、频率和测量工具方面采用同质程序来计算所报告效应的大小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b770/6877881/f6266d5c77bb/gr1.jpg

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