Lee Sook-Hyun, Lim Sung Min
Department of Clinical Research on Rehabilitation, Korea National Rehabilitation Research Institute, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2016;2016:3549878. doi: 10.1155/2016/3549878. Epub 2016 Jul 31.
Objective. To summarize and evaluate evidence for the effectiveness of acupuncture in relieving poststroke shoulder pain. Methods. Seven databases were searched without language restrictions. All randomized controlled trials that evaluated the effects of acupuncture for poststroke shoulder pain compared with controls were included. Assessments were performed primarily with the Visual Analogue Scale (VAS), Fugl-Meyer Assessment (FMA), and effective rates. Results. In all, 188 potentially relevant articles were identified; 12 were randomized controlled trials that met our inclusion criteria. Meta-analysis showed that acupuncture combined with rehabilitation treatment appeared to be more effective than rehabilitation treatment alone for poststroke shoulder pain, as assessed by VAS (weighted mean difference, 1.87; 95% confidence interval [CI], 1.20-2.54; <0.001); FMA (weighted mean difference, 8.70; 95% CI, 6.58-10.82; P < 0.001); and effective rate (RR, 1.31; 95% CI, 1.18-1.47; P < 0.001). Conclusions. Although there is some evidence for an effect of acupuncture on poststroke shoulder pain, the results are inconclusive. Further studies with more subjects and a rigorous study design are needed to confirm the role of acupuncture in the treatment of poststroke shoulder pain.
目的。总结并评估针刺缓解中风后肩痛有效性的证据。方法。检索七个数据库,无语言限制。纳入所有评估针刺治疗中风后肩痛效果并与对照组比较的随机对照试验。主要采用视觉模拟评分法(VAS)、Fugl-Meyer评估法(FMA)和有效率进行评估。结果。共识别出188篇潜在相关文章;12篇为符合纳入标准的随机对照试验。荟萃分析表明,与单纯康复治疗相比,针刺联合康复治疗对中风后肩痛似乎更有效,这通过VAS评估(加权平均差,1.87;95%置信区间[CI],1.20 - 2.54;P < 0.001);FMA评估(加权平均差,8.70;95% CI,6.58 - 10.82;P < 0.001);以及有效率评估(RR,1.31;95% CI,1.18 - 1.47;P < 0.001)得出。结论。尽管有一些证据表明针刺对中风后肩痛有效果,但结果尚无定论。需要更多受试者和更严谨研究设计的进一步研究来证实针刺在中风后肩痛治疗中的作用。