Systematic Evaluation And Meta Analysis Of Electroacupuncture In The Treatment Of Shoulder Syndrome After Stroke

Purpose:The effectiveness and safety of electroacupuncture in the treatment of shoulder-hand syndrome after stroke were evaluated by the method of evidence-based medicine,which provided evidence-based basis for the clinical application of electroacu-puncture in the treatment of shoulder-hand syndrome after stroke.Through the induction and research of randomized controlled trials,the selection rules of electroacupuncture and the influencing factors of related parameters were summarized to improve the quality of clinical research.Method:Refer to the manual evaluation of Cochrane system 5.1.0 version,making electronic search strategies,search China HowNet(CNKI,2005.1.1-2016.12.31),VIP database(VIP,2005.1.1-2016.12.31),Wan Fang database(WF,2005.1.1-2016.12.31),China biomedical databases(CBM,2005.1.1-2016.12.31),the Cochrane Library(Cochrane library,2005.1.1-2016.12.31),biomedical information database of the National Library of Medicine(Pubmed,2005.1.1-2016.12.31)in the treatment of shoulder hand syndrome after stroke literature.Using EndnoteX7 document management software to import documents,strictly screening,screening and extracting documents.The quality of the literature was assessed using the Jadad scale and the risk assessment tool in the Cochrane5.1.0 system evaluation manual.RevMan5.3 software was used to analyze the total effective rate and main symptom score of Meta.Result:1.The RCT study of 229 electroacupuncture in the treatment of shoulder-hand syndrome after stroke was obtained by electronic search.Only 16 RCT studies were included in the study,accounting for 6.98%of the total literature and 1434 patients.The improved Jadad score showed that three articles were high quality literature and 13 were low quality literatures.Cochrane risk assessment bias assessment results show that:1 for the highly biased risk literature,15 for the bias risk uncertainty literature.2.Electroacupuncture combined with rehabilitation training rehabilitation rehabilitation training:? electroacupuncture combined with rehabilitation treatment is more effective than rehabilitation group.RR = 1.22,95%CI[1.13,1.31].? The combination of electroacupuncture combined with rehabilitation training improves the Fugel-Meyer score better than conventional rehabilitation in improving the upper limb motor function of shoulder-hand syndrome after stroke.MD = 8.27,95%CI[5.76,10.78].?The combination of electroacupuncture combined with rehabilitation training in improving the visual analog scale scale VAS score and conventional rehabilitation training clinical difference is not.MD =-1.26,95%CI[-3.01,0.49].? Electroacupuncture combined with rehabilitation training in improving postganglionic shoulder hand syndrome,the daily living activity that ADL score is better than conventional rehabilitation training.MD = 9.074 and 95%CI[7.65,10.49].3.Electroacupuncture comparison rehabilitation training:? total effective rate of electroacupuncture treatment was significantly better than rehabilitation,RR = 1.15 and 95%CI[1.04,1.27].? electroacupuncture in improving upper limb motor function may be different from routine rehabilitation training.MD = 3.79,95%CI[-3.35,10.92].?electroacupuncture treatment in improving the visual analogue scale VAS score may be better than conventional rehabilitation training.MD =-1.44,95%CI[-2.35,-0.52]·? The effect of ADL score on the ability of daily exercise of shoulder surge syndrome after improvement of stroke was significantly better than that of rehabilitation.MD =-1.23 and 95%CI[-2.02,-0.44].4.Electroacupuncture compared to the needle:?electroacupuncture treatment of total effective rate is better than needle therapy,RR = 1.11 and 95%CI[1.05,1.? electroacupuncture treatment in the back of the hand swelling rate is better than the needle RR = 1.32,95%CI[1.19,1.46]?electroacupuncture treatment in the passive flexion pain pain rate is better than the needle RR = 1.31 and 95%CI[1.18,1.45].Conclusion:1.The system evaluation confirmed the efficacy of electro-acupuncture in the treatment of shoulder-hand syndrome after stroke,electroacupuncture in improving the total effective rate of patients with shoulder-hand stroke after stroke,improve pain,the daily living ability is better than rehabilitation training,Electroacupuncture in improving the stroke after shoulder hand syndrome in patients with total effective rate,hand back swelling rate,passive buckling pain pain rate is better than acupuncture acupuncture.Electroacupuncture combined with rehabilitation training in improving postganglionic shoulder hand syndrome in patients with total effective rate,upper limb motor function,daily living activity ability are significantly better than rehabilitation training.2.The systematic evaluation of the clinical study of the overall quality of the literature is not high,hope that after more high-quality clinical randomized controlled trials for electroacupuncture treatment of shoulder stroke after stroke clinical efficacy and electroacupuncture parameters in-depth study to provide the basis.