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针刺联合康复治疗对脊髓损伤患者恢复效果的Meta分析

Meta-Analysis on the Recovery Effect of Acupuncture Combined With Rehabilitation Therapy in Spinal Cord Injury Patients.

作者信息

Su Han, Zhou Binbin, Ji Xiaofeng, Li Bolin, Yang Xiangyu, Li Zhenxing

出版信息

Altern Ther Health Med. 2024 Jun 5.

Abstract

OBJECTIVE

To explore the recovery effect of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury through a systematic review of meta-analysis methods.

METHODS

Use "acupuncture," "electronic-acupuncture," "spinal cord," "spasm," and "paraplegia" as keywords, CNKI, Google, Wanfang, VIP, sci-hub, Web of Science, PubMed, and other Chinese or English databases were searched. To collect the domestic and foreign research on acupuncture combined with rehabilitation for muscle spasms in patients with spinal cord injury. Preliminary screening was conducted, and data extraction and quality evaluation were carried out on the included literature, including publication time, sample size, treatment methods, recovery effects, etc. According to the literature, the influence of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury and related indices was analyzed. The search period was from January 2018 to June 2023, and the selected research results were tested by RevMan5.3 software and data consolidation for consistency. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

RESULTS

A preliminary literature search yielded 172 papers. 53 papers from sci-hub, 71 papers from HowNet, 36 papers from Wanfang, and 12 papers from VIP. Finally, 10 articles that met the criteria were included, including 594 patients. According to different treatment methods, the literature about acupuncture combined with rehabilitation therapy for muscle spasms in patients with spinal cord injury was analyzed for consistency, and data were merged. It was concluded that acupuncture combined with rehabilitation The clinical curative effect of the experimental group of patients is higher than that of the control group MD=5.31, 95%CI (2.94, 7.81), Z=5.64, P < .001; the clinical effective rate of the experimental group is higher than that of the control group. The improvement of the clinical spasticity index (CSI) score index of the patients in the experimental group was better than that of the control group MD = -3.09, 95%CI (-4.51, -1.67), Z =4.28, P < .001; the MAS score of the patients in the experimental group The improvement was better than that of the control group MD =-0.76, 95%CI (-1.16, -0.38), Z=8.13, P < .001; the improvement of Barthel index (BI) in the experimental group was better than that of the control group MD=9.81, 95%CI (7.84,11.71), Z=12.71, P < .001; no adverse events were reported in the experimental group and the control group.

CONCLUSION

This study shows that acupuncture and rehabilitation are more effective than other therapeutic methods in the treatment of muscle spasms after spinal cord injury, and more randomized controlled trials are needed to verify this in the future.

摘要

目的

通过系统评价和Meta分析方法,探讨针刺联合康复治疗对脊髓损伤患者肌肉痉挛的恢复效果。

方法

以“针刺”“电针”“脊髓”“痉挛”“截瘫”为关键词,检索中国知网、谷歌、万方、维普、sci-hub、Web of Science、PubMed等中英文数据库。收集国内外关于针刺联合康复治疗脊髓损伤患者肌肉痉挛的研究。进行初步筛选,并对纳入文献进行数据提取和质量评价,包括发表时间、样本量、治疗方法、恢复效果等。根据文献分析针刺联合康复治疗对脊髓损伤患者肌肉痉挛及相关指标的影响。检索时间为2018年1月至2023年6月,选用的研究结果采用RevMan5.3软件进行检验和数据合并以评估一致性。采用纽卡斯尔-渥太华量表(NOS)评估纳入研究的方法学质量。

结果

初步文献检索得到172篇论文。来自sci-hub的有53篇,来自知网的有71篇,来自万方的有36篇,来自维普的有12篇。最终纳入10篇符合标准的文章,共594例患者。根据不同治疗方法,对针刺联合康复治疗脊髓损伤患者肌肉痉挛的文献进行一致性分析并合并数据。结果显示,针刺联合康复治疗的试验组患者临床疗效高于对照组,MD = 5.31,95%CI(2.94,7.81),Z = 5.64,P <.001;试验组临床有效率高于对照组。试验组患者临床痉挛指数(CSI)评分指标改善优于对照组,MD = -3.09,95%CI(-4.51,-1.67),Z = 4.28,P <.001;试验组患者改良Ashworth量表(MAS)评分改善优于对照组,MD = -0.76,95%CI(-1.16,-0.38),Z = 8.13,P <.001;试验组巴氏指数(BI)改善优于对照组,MD = 9.81,95%CI(7.84,11.71),Z = 12.71,P <.001;试验组和对照组均未报告不良事件。

结论

本研究表明,针刺与康复治疗脊髓损伤后肌肉痉挛比其他治疗方法更有效,未来需要更多随机对照试验来验证这一点。

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