针刺疗法治疗脑卒中后疲劳的疗效：系统评价和 Meta 分析。
Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis.
机构信息
School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang 330004, China.
Acupuncture and Tuina School, Jiangxi University of Chinese Medicine, Nanchang 330004, China.
出版信息
J Tradit Chin Med. 2023 Feb;43(1):27-33. doi: 10.19852/j.cnki.jtcm.20221006.003.
OBJECTIVE
To assess the effectiveness and safety of acupuncture for post-stroke fatigue (PSF).
METHODS
Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021. Meta-analysis was performed by using RevMan 5.4 software. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the certainty of evidence.
RESULTS
Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review. The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate [risk ratio () = 1.15, 95%(1.01, 1.33), = 0.04], reducing the FSS score [mean difference () =?－4.71, 95% ?(－6.22, －3.20), < 0.000 01] and FMA score [=?15.60, 95%?(11.96, 19.23), < 0.000 01]. Side effects of acupuncture were mild and rarely reported. The certainty of evidence of the outcomes based on the four trials was assessed as low.
CONCLUSIONS
The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients. However, high-quality RCTs are needed to further confirm these findings.
目的
评估针刺治疗中风后疲劳（PSF）的有效性和安全性。
方法
检索了 8 个在线数据库，以收集 2021 年 4 月之前发表的针刺治疗 PSF 的相关试验。使用 RevMan 5.4 软件进行荟萃分析。采用推荐、评估、发展和评估系统（Grading of Recommendations, Assessment, Development and Evaluation system）评估证据的确定性。
结果
确定了 4 项随机对照试验，共纳入 289 例 PSF 患者，进行了系统评价。荟萃分析结果显示，针刺组在提高有效率方面明显优于常规治疗组[风险比（RR）=1.15，95%置信区间（CI）（1.01，1.33），=0.04]，降低 FSS 评分[均数差（MD）=－4.71，95%CI（－6.22，－3.20），<0.00001]和 FMA 评分[MD=15.60，95%CI（11.96，19.23），<0.00001]。针刺的副作用轻微，很少有报道。基于这四项试验的结果的证据确定性评估为低。
结论
现有证据表明，针刺作为常规治疗的辅助手段可能对管理中风患者的疲劳有益。然而，需要高质量的 RCT 进一步证实这些发现。
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