|
针灸治疗中风后失语的系统评价再评价
|
Abstract:
目的:对针灸治疗中风后失语疗效的系统评价进行再评价。方法:利用PubMed、Embase、Web of science、CBM、VIP、WanFang Data和CNKI数据库,搜集针灸治疗中风后失语的系统评价/meta分析,检索时限为建库至2020年10月。由2名研究者独立筛选文献、提取资料,采用AMSTAR 2量表、PRISMA量表、GRADE工具评价纳入系统评价/Meta分析的方法学质量评价、报告质量和证据质量评价。结果:共纳入7篇相关系统评价和Meta分析,其中中文6篇,英文1篇,文献发表时间为2010年至2019年,包括48个结局指标。方法学质量均为极低,文献报告质量较低,证据质量等级大多为低质量和极低质量。结论:针灸治疗中风后失语的系统评价和Meta分析的方法学质量和文献报告质量较低,结局指标等级不高,临床上应对中医药研究进行循证医学的规范,以期提供高质量的证据。
Objective: In order to re-evaluate the systematic evaluation of acupuncture and moxibustion in the treatment of aphasia after stroke. Method: The databases such as PubMed, Embase, Web of science, CBM, VIP, WanFang Data and CNKI were searched for systematic reviews and Meta-analyses on the topic of acupuncture and moxibustion in the treatment of aphasia after stroke from inception to October, 2020. Two researchers independently screened the literature and extracted the data. AMSTAR 2 scale, PRISMA scale and GRADE tool evaluation were used to include methodological quality evaluation, report quality evaluation and evidence quality evaluation of systematic evaluation/Meta analysis. Results: A total of 7 relevant systematic evaluations and meta-analyses were finally included, including 6 in Chinese and 1 in English. The literature was published from 2010 to 2019, including 48 outcome indicators. The quality of methodology is critically low, the quality of literature report is low, and most of the quality of evidence is low and critically low. Conclusion: At present, systematic evaluation and meta-analysis of acupuncture and moxibustion in the treatment of aphasia after stroke have a low quality of methodological quality and literature report, and the level of outcome indicators is not high. In clinical practice, evidence-based medicine should be standardized in the study of traditional Chinese medicine in order to provide high- quality evidence.
[1] | Johnston, S.C., Mendis, S. and Mathers, C.D. (2009) Global Variation in Stroke Burden and Mortality: Estimates from Monitoring, Surveillance, and Modelling. The Lancet Neurology, 8, 345-354.
https://doi.org/10.1016/S1474-4422(09)70023-7 |
[2] | Engelter, S.T., Gostynski, M., Papa, S., Frei, M., et al. (2006) Epidemiology of Aphasia Attributable to First Ischemic Stroke—Incidence, Severity, Fluency, Etiology, and Thrombolysis. Stroke, 37, 1379-1384.
https://doi.org/10.1161/01.STR.0000221815.64093.8c |
[3] | 黄芳. 脑卒中失语症的康复治疗进展[J]. 中华物理医学与康复杂志, 2016, 38(6): 465-467. |
[4] | Flowers, H.L., Skoretz, S.A., Silver, F.L., et al. (2016) Poststroke Aphasia Frequency, Recovery, and Outcomes: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 97, 2188-2201.E8.
https://doi.org/10.1016/j.apmr.2016.03.006 |
[5] | 李志凤, 白玉龙. 脑卒中失语后抑郁症患者康复治疗的研究进展[J]. 中华物理医学与康复杂志, 2019, 41(4): 305-308. |
[6] | Mitchell, A.J., Sheth, B., Gill, J., Yadegarfar, M., et al. (2017) Prevalence and Predictors of Post-Stroke Mood Disorders: A Meta-Analysis and Meta-Regression of Depression, Anxiety and Adjustment Disorder. General Hospital Psychiatry, 47, 48-60. https://doi.org/10.1016/j.genhosppsych.2017.04.001 |
[7] | Bartoli, F., Di Brita, C., Crocamo, C., et al. (2018) Early Post-Stroke Depression and Mortality: Meta-Analysis and Meta-Regression. Frontiers in Psychiatry, 9, Article 530. https://doi.org/10.3389/fpsyt.2018.00530 |
[8] | 林志诚, 薛偕华, 江一静, 等. 中医康复临床实践指南?脑卒中[J]. 康复学报, 2019, 29(6): 6-9+15. |
[9] | 张通, 赵军, 白玉龙, 等. 中国脑血管病临床管理指南(节选版)——卒中康复管理[J]. 中国卒中杂志, 2019, 14(8): 823-831. |
[10] | Shea, B.J., Reeves, B.C., Wells, G., et al. (2017) AMSTAR 2: A Critical Appraisal Tool for Systematic Reviews That Include Randomised or Non-Randomised Studies of Healthcare Interventions, or Both. BMJ, 358, j4008.
https://doi.org/10.1136/bmj.j4008 |
[11] | Moher, D., Liberati, A., Tetzlaff, J. and Altman, D.G. (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Journal of Clinical Epidemiology, 62, 1006-1012.
https://doi.org/10.1016/j.jclinepi.2009.06.005 |
[12] | Guyatt, G., Oxman, A.D., Akl, E.A., et al. (2011) GRADE Guidelines: 1. Introduction-GRADE Evidence Profiles and Summary of Findings Tables. Journal of Clinical Epidemiology, 64, 383-394.
https://doi.org/10.1016/j.jclinepi.2010.04.026 |
[13] | 庞勇, 吴椋冰, 刘东华. 针刺治疗中风失语症疗效的系统评价[J]. 中国针灸, 2010, 30(7): 612-616. |
[14] | 魏文广. 针刺治疗中风后失语的系统评价[D]: [硕士学位论文]. 成都: 成都中医药大学, 2011. |
[15] | 潘东. 针灸治疗脑卒中后失语症临床疗效的Meta分析[J]. 山东医药, 2013, 53(42): 87-89. |
[16] | 张勇, 傅立新, 朱原, 等. 针刺治疗中风失语症疗效的系统评价[J]. 针灸临床杂志, 2014, 30(11): 62-65. |
[17] | 姜迎萍, 周益凡, 王波, 等. 针灸康复治疗中风失语症临床疗效的Meta分析[J]. 新疆医学, 2016, 46(10): 1237-1241. |
[18] | 朱文敏, 钟文娟, 徐波, 等. 针灸结合语言康复治疗脑卒中后失语症疗效的Meta分析[J]. 时珍国医国药, 2018, 29(8): 2038-2043. |
[19] | Zhang, B.L., Han, Y., Huang, X., et al. (2019) Acupuncture Is Effective in Improving Functional Communication in Post-Stroke Aphasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Wiener Klinische Wochenschrift, 131, 221-232. https://doi.org/10.1007/s00508-019-1478-5 |
[20] | Chen, Y.L., Zhao, C., Zhang, L., et al. (2018) Toward Evi-dence-Based Chinese Medicine: Status Quo, Opportunities and Challenges. Chinese Journal of Integrative Medicine, 24, 163-170. https://doi.org/10.1007/s11655-017-2795-2 |
[21] | 高杨阳, 吴琛, 耿久军, 赵玉茜, 王晓旭, 王京芳. 针灸治疗中风后失语症系统评价/Meta分析再评价[J]. 中国中医药信息杂志, 2022, 29(2): 22-27. |