Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang Hutong, Dongcheng District, 100700, Beijing, China.
Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 100029, Beijing, China.
Wien Klin Wochenschr. 2019 May;131(9-10):221-232. doi: 10.1007/s00508-019-1478-5. Epub 2019 Apr 18.
OBJECTIVE: In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients. METHODS: Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries. A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543). RESULTS: A total of 28 RCTs involving 1747 patients (883 patients in the treatment group and 864 patients in the control group) were included in the quantitative synthesis. The results demonstrated significant effects of acupuncture in improving PSA functional communication (P < 0.00001, standardized mean difference (SMD) = 1.01 [0.81, 1.20]), severity of impairment (P < 0.0001, SMD = 0.64 [0.45, 0.84]), spontaneous speech (P = 0.0002, SMD = 1.51 [0.71, 2.32]), auditory comprehension (P < 0.0001, SMD = 0.84 [0.43, 1.26]), repetition (P < 0.00001, SMD = 1.13 [0.75, 1.52]), naming (P = 0.03, SMD = 0.65 [0.08, 1.23]), reading (P < 0.0001, SMD = 1.56 [0.83, 2.29]), and writing (P = 0.009, SMD = 1.03 [0.25, 1.80]). CONCLUSION: Acupuncture seems to be effective in improving PSA functional communication and language function.
目的:本荟萃分析评价了针刺治疗脑卒中后失语症(post-stroke aphasia,PSA)患者的功能交流和语言功能的有效性。
方法:数据来源:检索了 MEDLINE、EMBASE、CENTRAL、AMED、SinoMed、CNKI、VIP 和万方数据库、ICTRP、ISRCTN、EUCTR、ClinicalTrials.gov 和 Stroke Trials Registries,纳入比较针刺与不治疗或安慰剂针刺对 PSA 影响的随机对照试验(randomized controlled trials,RCTs)。由两位作者独立筛选检索记录、提取数据,并评估纳入 RCT 的偏倚风险。采用 Review Manager Version 5.3 进行数据汇集和偏倚风险评估。方案在 PROSPERO 数据库(CRD42016037543)中注册。
结果:共纳入 28 项 RCT,涉及 1747 例患者(治疗组 883 例,对照组 864 例)。定量综合分析结果显示,针刺对改善 PSA 功能交流(P < 0.00001,标准化均数差 standardized mean difference,SMD 1.01 [0.81,1.20])、严重程度(P < 0.0001,SMD 0.64 [0.45,0.84])、自发言语(P = 0.0002,SMD 1.51 [0.71,2.32])、听觉理解(P < 0.0001,SMD 0.84 [0.43,1.26])、复述(P < 0.00001,SMD 1.13 [0.75,1.52])、命名(P = 0.03,SMD 0.65 [0.08,1.23])、阅读(P < 0.0001,SMD 1.56 [0.83,2.29])和书写(P = 0.009,SMD 1.03 [0.25,1.80])均有显著效果。
结论:针刺似乎能有效改善 PSA 的功能交流和语言功能。
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