针灸结合重复经颅磁刺激治疗中风后上肢运动功能：系统回顾和荟萃分析

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

NeuroRehabilitation Pub Date : 2023-12-22 DOI:10.3233/nre-230144

Yulong Xie, JuanHong Pan, Jia Chen, Di Zhang, Song Jin

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引用次数: 0

摘要

背景：中风后上肢运动功能障碍是影响患者运动功能和日常生活的重要因素。针灸和重复经颅磁刺激是中风康复的有效方法。然而，目前还缺乏对两者综合疗效的系统、全面的概述。目的：本研究旨在通过对随机对照试验进行系统回顾和荟萃分析，评估针灸联合重复经颅磁刺激对脑卒中后患者上肢运动功能的疗效。方法：在 PubMed、Embase、Cochrane Library、Web of Science CNKI、VIP、万方和 CBM 数据库中检索了针灸联合重复经颅磁刺激治疗脑卒中后上肢运动障碍的相关随机对照试验。筛选出符合纳入标准的临床试验后，由两名研究人员独立进行数据提取。使用 RevMan 5.4 软件进行 Meta 分析。结果：经过筛选，共纳入 18 篇文章，受试者总数为 1083 人。荟萃分析结果显示，联合疗法能有效改善患者的上肢运动功能（MD = 7.77，95%CI [6.32，9.22]，P < 0.05）、日常生活能力（MD = 8.53，95%CI [6.28，10.79]，P < 0.05）和肩关节偏瘫疼痛（MD = - 1.72，95%CI [- 2.26，- 1.18]，P < 0.05）。同时，在神经电生理指标方面，联合治疗可明显缩短运动诱发电位潜伏期和中枢运动传导时间（MD = - 1.42，95%CI [- 2.14， - 0.71]，P < 0.05）；（MD = - 0.47，95%CI [- 0.66， - 0.29]，P < 0.05），还可增加运动诱发电位振幅（SMD = 0.71，95%CI [0.28， 1.14]，P < 0.05）。结论：根据荟萃分析的结果，我们可以得出结论：针灸联合重复经颅磁刺激可以显著改善脑卒中患者的上肢运动功能和日常生活能力。

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Acupuncture combined with repeated transcranial magnetic stimulation for upper limb motor function after stroke: A systematic review and meta-analysis

BACKGROUND: Upper limb motor dysfunction after stroke is an important factor affecting patients’ motor function and daily life. Acupuncture and repetitive transcranial magnetic stimulation are effective methods for stroke rehabilitation. However, a systematic and comprehensive overview of the combined efficacy of the two is lacking. OBJECTIVE: Through a systematic review and meta-analysis of randomized controlled trials, this study aimed to assess the effectiveness of acupuncture combined with repetitive transcranial magnetic stimulation on upper extremity motor function in post-stroke patients. METHODS: The relevant randomized controlled trials on acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of upper limb motor disorders after stroke were searched in PubMed, Embase, Cochrane Library, Web of Science CNKI, VIP, Wanfang, and CBM databases. After screening clinical trials that met the inclusion criteria, data extraction was conducted independently by two investigators. Meta-analysis was performed using RevMan 5.4 software. RESULTS: After the screening, 18 articles were included, with a total of 1083 subjects. The results of meta-analysis showed that combination therapy could effectively improve the patients’ upper limb motor function (MD = 7.77, 95%CI [6.32, 9.22], P < 0.05), ability of daily living (MD = 8.53, 95%CI [6.28, 10.79], P < 0.05), and hemiplegic shoulder pain (MD = – 1.72, 95%CI [– 2.26, – 1.18], P < 0.05). Meanwhile, for neurophysiological indexes, combined treatment could significantly shorten the latency of motor evoked potential and central motor conduction time (MD = – 1.42, 95%CI [– 2.14, – 0.71], P < 0.05); (MD = – 0.47, 95%CI [– 0.66, – 0.29], P < 0.05), and also could increase the amplitude of motor evoked potential (SMD = 0.71, 95%CI [0.28, 1.14], P < 0.05). CONCLUSION: According to the results of the meta-analysis, we can conclude that acupuncture combined with repeated transcranial magnetic stimulation can significantly improve the upper limb motor function and daily living ability of stroke patients.

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来源期刊

NeuroRehabilitation CLINICAL NEUROLOGY-REHABILITATION

CiteScore

3.20

自引率

0.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： NeuroRehabilitation, an international, interdisciplinary, peer-reviewed journal, publishes manuscripts focused on scientifically based, practical information relevant to all aspects of neurologic rehabilitation. We publish unsolicited papers detailing original work/research that covers the full life span and range of neurological disabilities including stroke, spinal cord injury, traumatic brain injury, neuromuscular disease and other neurological disorders. We also publish thematically organized issues that focus on specific clinical disorders, types of therapy and age groups. Proposals for thematic issues and suggestions for issue editors are welcomed.