目的基于网状meta分析评价8种康复措施改善脑卒中后面瘫(FPS)的临床疗效。方法检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science核心合集数据库、Embase等数据库建库至2...目的基于网状meta分析评价8种康复措施改善脑卒中后面瘫(FPS)的临床疗效。方法检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science核心合集数据库、Embase等数据库建库至2025年5月不同康复措施治疗FPS的随机对照试验,运用RevMan 5.4、Stata 17.0软件进行数据处理和网状meta分析。结果26篇文献被纳入研究,根据网状meta分析结果和累积概率排序曲线下面积(SUCRA)排序结果显示,针刺疗法可显著改善FPS患者临床总有效率(OR=2.32,95%CI:0.18~4.45,P<0.05),并且效果最优(SUCRA=82.4);艾灸疗法可提高FPS患者面部残疾指数躯体功能(FDIP)评分(MD=11.58,95%CI:7.65~15.50,P<0.05),且效果最显著(SUCRA=91.3);肌内效贴疗法可降低FPS患者面部残疾指数社会功能(FDIS)评分(MD=9.61,95%CI:4.11~15.11,P<0.05),且疗效最有优势(SUCRA=97.9)和提高FPS患者House Brackmann(HB)面神经功能分级量表评分(MD=23.55,95%CI:8.51~38.59,P<0.05),且疗效最佳(SUCRA=88.7)。结论8种康复措施改善脑卒中后面瘫效果均优于常规治疗,针灸疗法、艾灸疗法、肌内效贴疗法在改善FDIP评分、FDIS评分及HB面神经功能分级量表评分方面表现优异,为临床提供一定的参考。展开更多
The remodeling process of synapses and neurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day （PSD） 0,7,21and 60, synaptophysin （p38...The remodeling process of synapses and neurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day （PSD） 0,7,21and 60, synaptophysin （p38）, NMDA receptor subunit 2A and AMPA receptor subunit 2 （GluR2） were observed by immunohistochemical method and semi-quantitative RT-PCR, respectively. Mean-while, the synaptic structure of the facial motorneurons was observed under a transmission electron microscope （TEM）. The intensity of p38 immunoreactivity was decreased, reaching the lowest value at PSD day 7, and then increased slightly at PSD 21. Ultrastructurally, the number of synapses in nucleus of the operational side decreased, which was consistent with the change in P38 immunoreactivity. NMDAR2A mRNA was down-regulated significantly in facial nucleus after the operation （P〈0.05）, whereas AMPAR2 mRNA levels remained unchanged （P〉0.05）. The synapses innervation and the expression of NMDAR2A and AMPAR2 mRNA in facial nucleus might be modified to suit for the new motor tasks following facial-facial anastomosis, and influenced facial nerve regeneration and recovery.展开更多
基金supported by a grant from the National Natural Science Foundation of China (No. 30600699).
文摘The remodeling process of synapses and neurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day （PSD） 0,7,21and 60, synaptophysin （p38）, NMDA receptor subunit 2A and AMPA receptor subunit 2 （GluR2） were observed by immunohistochemical method and semi-quantitative RT-PCR, respectively. Mean-while, the synaptic structure of the facial motorneurons was observed under a transmission electron microscope （TEM）. The intensity of p38 immunoreactivity was decreased, reaching the lowest value at PSD day 7, and then increased slightly at PSD 21. Ultrastructurally, the number of synapses in nucleus of the operational side decreased, which was consistent with the change in P38 immunoreactivity. NMDAR2A mRNA was down-regulated significantly in facial nucleus after the operation （P〈0.05）, whereas AMPAR2 mRNA levels remained unchanged （P〉0.05）. The synapses innervation and the expression of NMDAR2A and AMPAR2 mRNA in facial nucleus might be modified to suit for the new motor tasks following facial-facial anastomosis, and influenced facial nerve regeneration and recovery.
