Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China.
Acupuncture and Moxibustion Department, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China.
Medicine (Baltimore). 2024 Mar 1;103(9):e37167. doi: 10.1097/MD.0000000000037167.
Spastic paralysis is one of the most common sequelae of stroke, severely affecting patients' limb function and reducing their quality of life. Scalp acupuncture (SA) has been shown to significantly improve cerebral blood supply and reduce the severity of limb spasticity. This meta-analysis aims to systematically evaluate the clinical efficacy of SA in the treatment of post-stroke spastic paralysis, providing evidence-based medicine for clinical management of this condition.
We comprehensively searched databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Cochrane Library. Randomized controlled trials investigating the efficacy of SA in post-stroke spastic paralysis were identified until July 28, 2023. Meta-analysis was conducted using RevMan 5.4 and Stata17.0.
A total of 16 studies were included. Meta-analysis showed that the modified Ashworth spasticity assessment scale in the SA group was significantly higher than that in the rehabilitation group (mean difference [MD] = -0.56, 95% confidence interval [CI] [-0.75, -0.37], Z = 5.67, P < .00001). The simplified Fugl-Meyer motor function assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.86, 95% CI [3.26, 8.46], Z = 4.41, P < .0001). The modified Barthel index assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.79, 95% CI [4.73, 6.84], Z = 10.77, P < .00001). Additionally, the clinical effective rate in the SA group was significantly higher than that in the rehabilitation group (relative risk = 1.25, 95% CI [1.16, 1.36], Z = 5.42, P < .00001).
SA combined with rehabilitation therapy has certain advantages in reducing limb spasticity, improving limb function, and enhancing activities of daily living in patients with post-stroke spastic paralysis. This study provides reference and theoretical support for the promotion of SA in the treatment of this condition.
痉挛性瘫痪是中风最常见的后遗症之一，严重影响患者的肢体功能，降低其生活质量。头皮针刺（SA）已被证明可显著改善脑血流供应并减轻肢体痉挛的严重程度。本荟萃分析旨在系统评估 SA 在治疗中风后痉挛性瘫痪中的临床疗效，为该疾病的临床管理提供循证医学证据。
我们全面检索了中国知网、万方数据、维普中文科技期刊数据库、中国生物医学文献数据库、PubMed、Embase 和 Cochrane 图书馆等数据库，检索时间截至 2023 年 7 月 28 日，以获取评估 SA 治疗中风后痉挛性瘫痪疗效的随机对照试验。使用 RevMan 5.4 和 Stata17.0 进行荟萃分析。
共纳入 16 项研究。荟萃分析结果显示，SA 组改良 Ashworth 痉挛评定量表评分显著高于康复组（均数差[MD]=-0.56，95%置信区间[CI]：-0.75，-0.37]，Z=5.67，P<0.00001）；SA 组简化 Fugl-Meyer 运动功能评定量表评分显著高于康复组（MD=5.86，95%CI：3.26，8.46]，Z=4.41，P<0.0001）；SA 组改良 Barthel 指数评定量表评分显著高于康复组（MD=5.79，95%CI：4.73，6.84]，Z=10.77，P<0.00001）。SA 组临床有效率显著高于康复组（相对危险度[RR]=1.25，95%CI：1.16，1.36]，Z=5.42，P<0.00001）。
SA 联合康复疗法在降低中风后痉挛性瘫痪患者的肢体痉挛程度、改善肢体功能和提高日常生活活动能力方面具有一定优势。本研究为 SA 在该疾病治疗中的推广应用提供了参考和理论支持。
