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[电针治疗脑卒中后认知障碍:一项系统评价与Meta分析]

[Electroacupuncture for post stroke cognitive impairment: a systematic review and Meta-analyses].

作者信息

Zhan Jie, Wang Xuewen, Cheng Nanfang, Tan Feng

机构信息

Graduate School of Guangzhou University of CM, Guangzhou 510000, Guangdong Province, China; Foshan Hospital of TCM, Foshan 528000, Guangdong Province.

Foshan Hospital of TCM, Foshan 528000, Guangdong Province.

出版信息

Zhongguo Zhen Jiu. 2017 Oct 12;37(10):1119-25. doi: 10.13703/j.0255-2930.2017.10.025.

Abstract

OBJECTIVE

To systematically evaluate the efficacy and safety of electroacupuncture (EA) for post stroke cognitive impairment (PSCI).

METHODS

The randomized clinical trials (RCTs) regarding EA for PSCI published before October of 2016 were researched in China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), WanFang database, VIP medicine information system, PubMed and Cochrane Library. The literature screening and information extraction was conducted by two independent reviewers. The quality assessment was performed based on the guidance of the Cochrane Reviewers' Handbook, and Meta-analyses was performed by using RevMan 5.3 software.

RESULTS

Totally 14 RCTs were included, involving 896 PSCI patients. The results of Meta-analyses showed the EA group was superior to the control group in improving the MMSE [ =1.78, 95% (0.24, 3.32), =0.02], the MoCA [=1.92, 95% (0.96, 2.88), <0.000 1], P300 latency [ =-11.01, 95% (-18.91, -3.11), =0.000 6], P300 amplitude [=1.56, 95% (1.14, 1.98), <0.000 01], FMA score [ =10.74, 95% (2.67, 18.82), =0.009] and the clinical effective rate [ =1.37, 95% (0.98, 1.91), =0.06]. However, the comparison of BI score in both group had no significant differences [ =6.38, 95% (-2.41, 15.18), =0.15].

CONCLUSION

This Meta-analyses confirmed EA is effective and safe for PSCI, which could improve cognitive function and motor function. However, because of low quality of the included studies, more well-designed multicenter RCTs are needed.

摘要

目的

系统评价电针治疗脑卒中后认知障碍(PSCI)的疗效和安全性。

方法

检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、维普医药信息系统、PubMed及Cochrane图书馆,收集2016年10月以前发表的关于电针治疗PSCI的随机对照试验(RCT)。由两名独立评价员进行文献筛选和信息提取。依据Cochrane系统评价员手册的指导进行质量评估,使用RevMan 5.3软件进行Meta分析。

结果

共纳入14项RCT,涉及896例PSCI患者。Meta分析结果显示,电针组在改善简易精神状态检查表(MMSE)[ =1.78,95%可信区间(CI)(0.24,3.32), =0.02]、蒙特利尔认知评估量表(MoCA)[ =1.92,95%CI(0.96,2.88),<0.000 1]、P300潜伏期[ = -11.01,95%CI(-18.91,-3.11), =0.000 6]、P300波幅[ =1.56,95%CI(1.14,1.98),<0.000 01]、Fugl-Meyer评估量表(FMA)评分[ =10.74,95%CI(2.67,18.82), =0.009]及临床有效率[ =1.37,95%CI(0.98,1.91), =0.06]方面均优于对照组。然而,两组间巴氏指数(BI)评分比较差异无统计学意义[ =6.38,95%CI(-2.41,15.18), =0.15]。

结论

本Meta分析证实电针治疗PSCI有效且安全,可改善认知功能和运动功能,但因纳入研究质量较低,尚需更多设计严谨的多中心RCT进一步验证。

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