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[4种针刺疗法治疗中风后肩手综合征的网状Meta分析]

[Network Meta-analysis of 4 acupuncture therapies for shoulder hand syndrome after stroke].

作者信息

Wang Rui-Qi, Wu Qing-Zhong, Huang Chun-Hua, Rao Wang-Fu

机构信息

Graduate School of Jiangxi University of TCM, Nanchang 330006, China.

Affiliated Hospital of Jiangxi University of TCM, Nanchang 330006.

出版信息

Zhongguo Zhen Jiu. 2021 May 12;41(5):563-9. doi: 10.13703/j.0255-2930.20200325-k0011.

Abstract

OBJECTIVE

A network Meta-analysis of randomized controlled trials (RCT) of 4 commonly used acupuncture therapies (electroacupuncture, fire needling, warming acupuncture and filiform needling) for shoulder hand syndrome (SHS) after stroke was performed.

METHODS

The RCTs regarding electroacupuncture, fire needling, warming acupuncture and filiform needling for SHS after stroke before March 10, 2020 were searched in databases of CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library. The included literature was screened and evaluated by Cochrane bias risk assessment tool, and the data analysis was performed by RevMan5.3, Gemtc0.14.3 and Stata14.2.

RESULTS

A total of 21 RCTs were included, involving 1508 patients, 814 cases in the observation group and 694 cases in the control group. In term of effective rate and visual analogue scale (VAS) score, warming acupuncture, electroacupuncture and fire needling needling were superior to western medication and rehabilitation (<0.05), and warming acupuncture was most likely to be the best treatment. In term of joint swelling score, warming acupuncture was superior to rehabilitation (<0.05), and warming acupuncture was most likely to be the best treatment. In term of Fugl-Meyer assessment (FMA) score, fire needling was superior to western medication and rehabilitation (<0.05), warming acupuncture was superior to filiform needling (<0.05), fire needling was most likely to be the best treatment (<0.05).

CONCLUSION

The curative effect of 4 acupuncture therapies for SHS after stroke is better than the western medication and rehabilitation, and warming acupuncture has the best clinical efficacy.

摘要

目的

对4种常用针刺疗法(电针、火针、温针灸和毫针)治疗中风后肩手综合征(SHS)的随机对照试验(RCT)进行网状Meta分析。

方法

检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、EMbase和Cochrane图书馆数据库中2020年3月10日前关于电针、火针、温针灸和毫针治疗中风后SHS的RCT。采用Cochrane偏倚风险评估工具对纳入文献进行筛选和评价,并用RevMan5.3、Gemtc0.14.3和Stata14.2进行数据分析。

结果

共纳入21项RCT,涉及1508例患者,观察组814例,对照组694例。在有效率和视觉模拟量表(VAS)评分方面,温针灸、电针和火针优于西药和康复治疗(<0.05),温针灸最有可能是最佳治疗方法。在关节肿胀评分方面,温针灸优于康复治疗(<0.05),温针灸最有可能是最佳治疗方法。在Fugl-Meyer评估(FMA)评分方面,火针优于西药和康复治疗(<0.05),温针灸优于毫针(<0.05),火针最有可能是最佳治疗方法(<0.05)。

结论

4种针刺疗法治疗中风后SHS的疗效优于西药和康复治疗,温针灸临床疗效最佳。

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