中医传统运动疗法对中风偏瘫患者康复疗效的Meta分析
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国家自然科学基金项目(81774146);首都临床特色应用研究与成果推广项目(Z171100001017150);北京市医管局培育项目(PZ2018008)


The Effect of Traditional Chinese Medicine Exercises on the Rehabilitation of Patients with Hemiplegia after a Stroke:A Meta-analysis of Randomized Controlled Trials
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    摘要:

    目的:评价中医传统运动疗法对中风后偏瘫患者的康复效果。方法:计算机检索国内外8个数据库,纳入4种中医传统运动疗法(太极拳、八段锦、五禽戏、易筋经)对中风后偏瘫患者康复疗效的随机对照文献,采用Cochrane协作网的偏倚风险评估工具进行质量评价,应用RevMan53软件进行数据分析。结果:共纳入17篇文献,1 000例中风病患者。4种中医传统运动疗法组在改善肢体运动功能方面均优于对照组。在治疗30 d内、30~60 d、60 d后,中医传统运动疗法组在改善运动功能、平衡功能、日常生活能力方面均优于对照组。在改善下肢运动功能方面,治疗30 d后,中医传统运动疗法组优于对照组(436[302,570]);但治疗30 d内2组的评分比较差异无统计学意义(113[-034,261])。中风后6个月内、6个月后的中医传统运动疗法组在改善肢体运动功能、平衡功能、日常生活能力方面均优于对照组。在改善下肢运动功能方面,中风后6个月内的中医传统运动疗法组优于对照组(397[263,531]),但7个月内2组的评分比较差异无统计学意义(068[-114,250])。结论:中医传统运动疗法能够改善中风后偏瘫患者的肢体运动功能、平衡功能以及日常生活能力,但是由于下肢运动功能改善方面的文献较少,各亚组的结论不一致。因此,期望日后开展更多高质量、大样本、多个测量时点的随机对照试验进一步验证疗效。

    Abstract:

    The objective of this meta-analysis was to evaluate the effectiveness of traditional Chinese medicine (TCM) exercises on the rehabilitation of post-stroke hemiplegic patientsMethods:On retrieving eight databases on a computer,we investigated the results of randomized controlled trials (RCTs) on the efficacy of four TCM exercises (taiji,baduanjin,wuqinxi,and yijining) in the rehabilitation of post-stroke hemiplegic patientsThe Cochrane risk of bias tool was used to estimate the quality of the literatures,and RevMan53 was utilized to analyse the dataResults:A total of 17 articles were included,encompassing 1 000 stroke patientsFour TCM exercise groups were superior to the control group in improving the limb motor functionWithin 30 days,30~60 days,and after 60 days of treatment,the TCM exercise group was superior to the control group in terms of improving the motor function,balance function,and daily living abilityIn terms of improving the lower limb motor function,the TCM exercise group was superior to the control group after 30 days of treatment(436[302,570]); however,there was no significant difference in the FMA-L scores between the two groups within 30 days of treatment(113[-034,261])Within 6 months and after 6 months post stroke,the TCM exercise group was better than the control group at improving the limb motor function,balance function,and daily living abilityIn terms of improving the lower limb motor function,the TCM exercise group was superior to the control group within 6 months after stroke(397[263,531]),but no significant difference was found in the FMA-L scores of the two groups within 7 months(068[-114,250])Conclusion:The results of this meta-analysis revealed that TCM exercises can improve the limb motor function,balance function,and daily living ability in patients with hemiplegia after strokeHowever,because of the lack of literature on lower limb movement,the outcomes of each subgroup were inconsistentTherefore,more RCTs with high-quality,large sample sizes,and multiple measurement time points are required.

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房位昊,李博,王肖南,丁潇,张虎,魏青.中医传统运动疗法对中风偏瘫患者康复疗效的Meta分析[J].世界中医药,2021,(15).

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  • 收稿日期:2020-02-12
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  • 在线发布日期: 2021-08-16
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