摘要
目的:系统评价经正中神经电刺激(Median nerve electrical stimulation,MNES)治疗意识障碍患者的有效性。方法:计算机检索Te Cochrane Library、PubMed、EMbase、CNKI、CBM、VIP和WanFang Data数据库,收集有关正中神经电刺激治疗意识障碍患者的随机对照试验(RCT),检索时限均为建库至2015年5月。由2位研究者独立进行文献筛选、资料提取和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。结果:共纳入9个研究768例患者,其中观察组383例,对照组380例。Meta分析结果显示,观察组在治疗后格拉斯评分(glasgow coma scale,GCS)提高,治疗后1周[MD=2.24,95%CI(1.47,3.01),P<0.01]、2周[MD=1.40,95%CI(0.64,2.16),P<0.01]和4周[MD=2.17,95%CI(1.56,2.78),P<0.01]的GCS评分提高水平均优于对照组,有统计学意义;2组在刺激后苏醒率比较,观察组优于对照组[RR=1.43,95%CI(1.20,1.72),P<0.01],有统计学意义。结论:现有证据表明,经正中神经电刺激治疗意识障碍患者的有效性高于对照组,但是受纳入研究的质量和数量限制,上述结论尚需今后开展更多高质量、大样本、设计严格的RCT进行验证。
Objective：To systematically review the effectiveness of median nerve electrical stimulation （MNES） for patients with disturbance of consciousness. Methods： Such databases as the Coehrane Library, PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were electronically searched from inception to May 2015 for randomized con- trolled trials on MNES for patients with disturbance of consciousness. Two reviewers independently screened litera- ture, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed u- sing RevMan 5.3 software. Results： A total of 9 trials were included, involving 768 patients： 383 patients in the ex perimental group and 380 patients in the control group . The results of meta-analysis showed that after MNES, the scores of Glasgow Coma Scale （GCS） in the experimental group were increased after one week [MD - 2.24, 95% CI （1.47, 3.01）, P〈0. 00001], 2 weeks [MD - 1.40, 95% CI （0.64, 2.16）, P〈0. 0003] and 4 weeks EMD = 2.17, 95 % CI （1.56, 2.78）, P〈0. 000011, as compared with control group with the differences being statistically significant. The revival rate in the experimental group was higher than in the control group ERR = 1.43, 95~ CI （1.20, 1.72）, P%0. 00011 with the difference being statistically significant. Conclusion： Current evidence shows that patients with disturbance of consciousness who received MNES had better recovery than the control group. Be- cause of the quality and quantity restrictions included in the study, this conclusion still needs more high quality, large sample, rigorous RCTs to verify.
出处
《中国康复》
2016年第2期134-137,共4页
Chinese Journal of Rehabilitation
关键词
意识障碍
正中神经电刺激
META分析
Consciousness
Median nerve electrical stimulation
Meta analysis
