文章摘要
杨春生,陈祢,王宝兰.正中神经电刺激治疗意识障碍患者有效性的Meta分析[J].中国康复,2016,31(2):134-137
正中神经电刺激治疗意识障碍患者有效性的Meta分析
Effectiveness of the median nerve electrical stimulation treatment on patients with disturbance of consciousness-Meta analysis
  
DOI:
中文关键词: 意识障碍  正中神经电刺激  Meta分析
英文关键词: Consciousness  Median nerve electrical stimulation  Meta-analysis
基金项目:
作者单位
杨春生 新疆医科大学第一附属医院康复医学科乌鲁木齐 830000 
陈祢 新疆医科大学第一附属医院康复医学科乌鲁木齐 830000 
王宝兰 新疆医科大学第一附属医院康复医学科乌鲁木齐 830000 
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中文摘要:
  目的:系统评价经正中神经电刺激(Median nerve electrical stimulation,MNES)治疗意识障碍患者的有效性。方法:计算机检索Te Cochrane Library、PubMed、EMbase、CNKI、CBM、VIP和WanFang Data数据库,收集有关正中神经电刺激治疗意识障碍患者的随机对照试验(RCT),检索时限均为建库至2015年5月。由2位研究者独立进行文献筛选、资料提取和评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。结果:共纳入9个研究768例患者,其中观察组383例,对照组380例。Meta分析结果显示,观察组在治疗后格拉斯评分(glasgow coma scale, GCS)提高,治疗后1周[MD=2.24,95%CI(1.47,3.01),P<0.01]、2周[MD=1.40,95%CI(0.64,2.16),P<0.01]和4周[MD=2.17,95%CI(1.56,2.78),P<0.01]的GCS评分提高水平均优于对照组,有统计学意义;2组在刺激后苏醒率比较,观察组优于对照组[RR=1.43,95%CI(1.20,1.72),P<0.01],有统计学意义。结论:现有证据表明,经正中神经电刺激治疗意识障碍患者的有效性高于对照组,但是受纳入研究的质量和数量限制,上述结论尚需今后开展更多高质量、大样本、设计严格的 RCT 进行验证。
英文摘要:
  Objective:To systematically review the effectiveness of median nerve electrical stimulation (MNES) for patients with disturbance of consciousness. Methods:Such databases as the Cochrane Library, PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were electronically searched from inception to May 2015 for randomized controlled trials on MNES for patients with disturbance of consciousness. Two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results:A total of 9 trials were included, involving 768 patients: 383 patients in the experimental group and 380 patients in the control group . The results of meta-analysis showed that after MNES, the scores of Glasgow Coma Scale (GCS) in the experimental group were increased after one week [MD = 2.24, 95% CI (1.47, 3.01), P<0.00001], 2 weeks [MD = 1.40, 95% CI (0.64, 2.16), P<0.0003] and 4 weeks [MD = 2.17, 95% CI (1.56, 2.78), P<0.00001], as compared with control group with the differences being statistically significant. The revival rate in the experimental group was higher than in the control group [RR = 1.43, 95% CI (1.20, 1.72), P<0.0001] with the difference being statistically significant. Conclusion:Current evidence shows that patients with disturbance of consciousness who received MNES had better recovery than the control group. Because of the quality and quantity restrictions included in the study, this conclusion still needs more high-quality, large sample, rigorous RCTs to verify.
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