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针对缺血性中风的影响:一个系统的综述与元分析和试验顺序分析
Xiaoying Zhong1, Xiaochao Luo2, Ling Li2
1Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; State Key Laboratory of Traditional Chinese Medicine Syndrome/School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China; Intelligent Chinese Medicine Research Institute, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China.
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概括
针在缺血性中风患者中显著改善神经功能,残疾和日常生活活动. 试验的顺序分析证实了强有力的发现,尽管需要更多高质量的试验.
科学领域:
- 神经学 神经学
- 综合医学是一个整体医学.
- 基于证据的医学基于证据的医学.
背景情况:
- 针是一种常见的治疗缺血性中风,但它的有效性需要进一步研究.
- 现有的随机对照试验 (RCT) 可能缺乏足够的统计能力来最终评估针的影响.
- 本综述综合了评估针对缺血性中风恢复的影响的证据.
研究的目的:
- 系统地审查和综合治疗缺血性中风的有效性证据.
- 评估目前针对缺血性中风针的随机对照试验 (RCT) 的统计能力和稳定性.
- 评估有关针在中风恢复中的益处的证据的确定性.
主要方法:
- 在7个数据库和2个注册表中系统搜索到2023年6月13日的RCT.
- 使用柯克兰偏差风险2工具进行偏差风险评估.
- 使用随机效应模型的元分析;结果包括神经功能 (NIHSS),全球残疾 (mRS) 和ADL (BI/MBI).
- 使用GRADE评估证据的确定性;通过试验序列分析 (TSA) 评估可靠性.
主要成果:
- 纳入了40个具有4485名患者的RCT.
- 针显著改善了NIHSS (神经功能),但证据的确定性很低.
- 在mRS (全球残疾) 和BI/MBI (ADLs) 中也观察到显著改善,证据确定性中等至低.
- 交通安全局证实了足够的样本大小和各个结果的强有力的结果.
结论:
- 目前的证据表明,针有效地改善了缺血性中风患者的神经功能,全球残疾和ADL.
- 这些发现是强有力的,得到了TSA的支持,表明针的治疗潜力.
- 建议进一步进行高质量的RCT,以提高证据的确定性 (目前中等到低).
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