摘要
目的对针灸疗法治疗中风后痉挛性瘫痪的系统评价的方法学质量和证据质量进行再评价。方法计算机检索CNKI、CBM、The Cochrane Library、PubMed和EMbase数据库,搜集针灸疗法治疗中风后痉挛性瘫痪的系统评价,检索时限均为建库至2018年12月16日。由2位评价员独立筛选文献、提取资料后,使用AMSTAR 2量表和GRADE系统分别对纳入研究的方法学及证据质量等级进行评价。结果共纳入7篇系统评价,其结果显示,针灸疗法治疗中风后痉挛性瘫痪具有明显优势且无明显不良反应。AMSTAR 2量表评价结果显示,关键条目2和7不达标,导致其方法学质量均为极低。GRADE系统评价结果显示,46.15%为低级证据质量,42.31%为中级,11.54%为极低级,无证据质量显示为高级。结论当前证据显示针灸疗法治疗中风后痉挛性瘫痪具有一定疗效,但相关系统评价证据的方法学质量和结局指标的可靠程度均较低,其相关研究急待进一步规范,未来应在研究设计时适当结合中医特色,以期获得更高质量的临床证据。
Objectives To evaluate the quality of methodology and evidence of the exiting systematic reviews(SRs) of acupuncture therapy for post-stroke spastic paralysis. Methods CNKI, CBM, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect SRs of acupuncture therapy for post-stroke spastic paralysis from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data, and evaluated the quality of methodology and evidence by AMSTAR 2 scale and GRADE system. Results A total of 7 SRs were included.The results showed that acupuncture therapy had obvious advantages in treating post-stroke spastic paralysis without obvious adverse reactions. The results of AMSTAR 2 scale showed that the failure of key items 2 and 7 resulted in extremely low methodological quality. The results of GRADE system showed that 46.15% of which were low-level evidence quality, 42.31% were medium, 11.54% were extremely low, and no evidence quality were high. Conclusions Current evidence shows that acupuncture and moxibustion therapy is effective in treating spastic paralysis after stroke,however, the quality of the SRs is low. The studies are required to be standardized and combined with the characteristics of TCM to obtain high quality evidence in the future.
作者
杨晗
李涓
李雨谿
叶静
钟冬灵
张亚
肖奇蔚
王旭
任玉兰
梁繁荣
YANG Han;LI Juan;LI Yuxi;YE Jing;ZHONG Dongling;ZHANG Ya;XIAO Qiwei;WANG Xu;REN Yulan;LIANG Fanrong(Chengdu University of TCM,Chengdu,610075,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2019年第10期1233-1239,共7页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目（编号：81590950）
