Acupuncture and Tuina Department, Changchun University of Chinese Medicine, Changchun, China.
Department of Proctology, Second Affiliated Hospital of Heilongjiang University Of Chinese Medicine, Haerbin, China.
Medicine (Baltimore). 2022 Nov 18;101(46):e31847. doi: 10.1097/MD.0000000000031847.
To provide evidence, this review evaluated the methodological quality, risk of bias, and reporting quality of SRs/MAs in the treatment of shoulder-hand syndrome after stroke with acupuncture.
Systematic reviews and Meta analyses (SRs/MAs) of acupuncture for shoulder and hand syndromes after stroke were retrieved from 6 databases from inception to May 1, 2022. Two reviewers independently screened the literature and extracted the data, then used Assessment of Multiple Systematic Reviews-2 (AMSTAR-2), Bias Risk in Systematic Review (ROBIS), and Preferred Report Item for Systematic review and Meta-analysis (PRISMA), Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess methodological quality, risk of bias, quality of reporting, and quality of evidence.
We included 7 SRs/MAs, of which all SRs/MAs had very low AMSTAR-2 assessment quality and one study had a very low assessment bias risk. According to the PRISMA checklist, Protocol and registration, Synthesis of results, Summary of evidence, Conclusions and Funding were the main reporting limitations. GRADE evaluation showed a total of 37 results, but no high-quality evidence results, 6 results (16.22%) of the evidence quality were moderate, and supported acupuncture combined with exercise rehabilitation and drug therapy was better than exercise joint drug rehabilitation and rehabilitation, we also found that the result of limitations were the main factors that influence the evidence of low quality, followed by imprecision, inconsistency, and publication bias.
Acupuncture is a relatively safe and effective adjuvant therapy for shoulder and hand syndromes after stroke. However, because of the low quality of SRs/MAs evidence supporting these findings, high-quality randomized controlled trials should be conducted, and the quality of relevant SRs should be improved to provide evidence for clinical application.
为了提供证据，本综述评估了针刺治疗中风后肩手综合征的系统评价/荟萃分析（SRs/MAs）的方法学质量、偏倚风险和报告质量。
从 6 个数据库中检索到 2022 年 5 月 1 日之前关于针刺治疗中风后肩手综合征的系统评价/Meta 分析。两名评审员独立筛选文献并提取数据，然后使用评估多个系统评价-2（AMSTAR-2）、系统评价偏倚风险（ROBIS）、系统评价和 Meta 分析首选报告条目（PRISMA）、推荐评估、制定与评价（GRADE）来评估方法学质量、偏倚风险、报告质量和证据质量。
我们纳入了 7 篇 SRs/MAs，其中所有 SRs/MAs 的 AMSTAR-2 评估质量均为极低，有一篇研究的偏倚风险评估为极低。根据 PRISMA 清单，主要的报告局限性包括方案和注册、结果综合、证据总结、结论和资金。GRADE 评价显示共有 37 个结果，但没有高质量证据结果，6 个结果（16.22%）的证据质量为中等，支持针刺联合运动康复和药物治疗优于运动关节药物康复和康复，我们还发现，局限性的结果是影响低质量证据的主要因素，其次是不精确性、不一致性和发表偏倚。
针刺是中风后肩手综合征的一种相对安全有效的辅助治疗方法。然而，由于支持这些发现的 SRs/MAs 证据质量较低，应进行高质量的随机对照试验，并提高相关 SRs 的质量，为临床应用提供证据。
