中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (8): 1308-1314.doi: 10.4103/1673-5374.213551

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

醒脑开窍针刺法治疗急性缺血性卒中：安全及有效性的Meta分析

  

  • 收稿日期:2017-06-26 出版日期:2017-08-15 发布日期:2017-08-15
  • 基金资助:

    河北省高校悲鸣优秀人才支持计划(II)( BR2-104)

Xingnao Kaiqiao needling method for acute ischemic stroke: a meta-analysis of safety and efficacy

Zhi-xin Yang1, Jia-hong Xie2, Ding-ding Liu3   

  1. 1 Department of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China;
    2 Key Laboratory of Traditional Chinese Medicine Research and Development, Institute of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China;
    3 School of Traditional Chinese Medicine, North China University of Science and Technology, Tangshan, Hebei Province, China
  • Received:2017-06-26 Online:2017-08-15 Published:2017-08-15
  • Contact: Zhi-xin Yang, Ph.D.,yzx19972003@163.com.
  • Supported by:

    This study was supported by the Support Program (II) of Hundreds of Universities Outstanding Innovative Talents in Hebei Province of China, No. BR2-104.

PDF

354

摘要：

 

目的：评估醒脑开窍针法治疗急性缺血性卒中的有效性和安全性。
资料来源：检索2006年6月至2016年3月中国知网、维普、万方医学、中国生物医学文献数据库、Cochrane图书馆及PubMed数据库，检索应用醒脑开窍针法治疗急性缺血性卒中的随机对照研究。
资料选择：分析采用醒脑开窍针法与常规药物或其他针灸方法等对比治疗急性缺血性脑卒中的随机和半随机临床对照试验。根据Cochrane评价手册5.1对文章质量进行评价，采用Cochrane系统评价方法进行研究。以RevMan 5.2软件行Meta分析。
结局评价指标：病死率、致残率、日常生活活动能力及临床疗效。
结果：共纳入符合标准的12项研究。Meta分析结果显示，与常规药物或其他针灸方法相比，醒脑开窍针法可降低急性缺血性脑卒中的残疾率[RR=0.51, 95%CI(0.27,0.98), z=2.03, P<0.05]，提高其日常生活活动能力[WMD=12.23,95%CI (3.66,20.08, z=2.80, P<0.005]及疗效[RR=1.61, 95%CI(1.23,2.09) z=3.53, P<0.0004]，但对于患者死亡率的影响与常规药物或其他针灸方法接近[RR=0.61, 95%CI (0.15, 2.45), z=0.70, P>0.05]。

结论：醒脑开窍针法治疗急性缺血性脑卒中是安全有效的，但本次纳入的研究存在选择性偏倚、测量偏倚的可能性较高，尚需更多高质量随机对照研究提供可靠证据，因此醒脑开窍针法治疗急性缺血性卒中的有效性和安全性善待进一步研究。

orcid:0000-0003-3755-5977(Zhi-xin Yang)

关键词: 神经再生, 醒脑开窍针法, 急性缺血性脑卒中, Meta分析, 系统评价, 日常生活活动能力, Barthel指数, 死亡率, 致残率, 疗效

Abstract:

OBJECTIVE: To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.
DATA SOURCES: We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed were searched from June 2006 to March 2016.
DATA SELECTION: We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according
to the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1), and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for the meta-analysis of the included studies.
OUTCOME MEASURES: The mortality rate, disability rate, activities of daily living (Barthel Index), and clinical efficacy were observed.
RESULTS: Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.27–0.98, z = 2.03, P < 0.05], elevated the  activities of daily living (weighted mean difference = 12.23, 95% CI: 3.66–20.08, z = 2.80, P < 0.005), and had greater clinical efficacy (RR = 1.61, 95% CI: 1.23–2.09, z = 3.53, P < 0.0004). However, there was no significant difference in mortality rate (RR = 0.61, 95% CI: 0.15–2.45, z = 0.70, P > 0.05).
CONCLUSION: The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality randomized controlled trials are needed to provide reliable evidence of the efficacy and safety of Xingnao Kaiqiao acupuncture in the treatment of acute ischemic stroke.

Key words: nerve regeneration, Xingnao Kaiqiao needling method, acute ischemic stroke, meta-analysis, systematic review, activities of daily living, Barthel index, mortality, disability rate, clinical efficacy, neural regeneration