文献类型：期刊文献

中文题名：针刺结合重复经颅磁刺激治疗脑卒中后运动性失语疗效的Meta分析

英文题名：Meta-analysis of the Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Acupuncture for Post-Stroke Motor Aphasia

作者：张志东[1];金华[1];胡继宏[1,2,3];靳利梅[1];张扬[1,2];蒋露[1];王莉[1]

第一作者：张志东

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学敦煌医学与转化教育部重点实验室,甘肃兰州730000;[3]甘肃中医药大学教学实验实训中心,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2025

卷号：34

期号：3

起止页码：382

中文期刊名：中国中医急症

外文期刊名：Journal of Emergency in Traditional Chinese Medicine

基金：国家自然科学基金项目(81960614);甘肃省中医方药挖掘与创新转化重点实验室开放基金项目(FYWJ-24-01);甘肃省国际科技合作重点研发项目(20YF3WA020)。

语种：中文

中文关键词：脑卒中;运动性失语;针刺;rTMS;Meta分析

外文关键词：Stroke;Motor aphasia;Acupuncture;rTMS;Meta-analysis

摘要：目的使用Meta分析评价针刺结合重复经颅磁刺激(rTMS)治疗中风后运动性失语症患者的疗效。方法检索维普网(VIP)、中国知网全文数据库(CNKI)、中国生物医学文献数据库(CBM)及万方数据库(WanFang)等中文数据库与PubMed、Cochrane Library、Web of Science等英文数据库。检索策略为“针灸”and“重复经颅磁刺激”and“脑卒中”and“运动性失语”and“随机对照试验”,检索时限为自建库至2024年9月15日,文献质量采用Cochrane偏倚风险评估方法和传统Jadad量表进行评价,Meta分析和敏感性分析使用RevMan 5.2和Stata 15.0软件进行。结果最终选取了15篇研究文献(Jadad≥3分),对纳入的1080例中风后运动性失语的患者进行Meta分析,针刺联合rTMS治疗在总有效率[RR=1.17,95%CI(1.10,1.25),P<0.05],AQ评分[MD=9.15,95%CI(8.06,10.24),P<0.05],WAB言语评分[MD=1.71,95%CI(0.98,2.43),P<0.05],ABC言语评分[SMD=1.04,95%CI(0.76,1.31),P<0.05]改善程度上优于对照组。亚组分析表明疗程的长短可能是WAB言语评分异质性较大的部分原因。结论与单纯使用针刺、rTMS或者基础治疗相比,针刺联合rTMS治疗脑卒中后运动性失语有更好的疗效。
Objective:To evaluate the efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with acupuncture for post-stroke motor aphasia using meta-analysis.Methods:The following databases were searched:VIP Database,China National Knowledge Infrastructure(CNKI),China Biology Medicine Database(CBM),WanFang Data,as well as English-language databases including PubMed,Cochrane Library,and Web of Science.The search strategy was:"acupuncture"AND"repetitive transcranial magnetic stimulation"AND"stroke"AND"motor aphasia"AND"randomized controlled trial."The search time frame covered from the inception of each database to September 15,2024.The quality of the included studies was assessed using the Cochrane Risk of Bias tool and the traditional Jadad scale.Meta-analysis and sensitivity analysis were conducted using RevMan 5.2 and Stata 15.0 software.Results:A total of 15 studies(Jadad score≥3)were finally selected,involving 1,080 patients with post-stroke motor aphasia.The meta-analysis showed that the combination of acupuncture and rTMS treatment was superior to the control group in terms of overall efficacy rate[RR=1.17,95%CI(1.10,1.25),P<0.05],AQ score[MD=9.15,95%CI(8.06,10.24),P<0.05],WAB verbal score[MD=1.71,95%CI(0.98,2.43),P<0.05],and ABC verbal score[SMD=1.04,95%CI(0.76,1.31),P<0.05].Subgroup analysis indicated that the duration of treatment might be one of the main reasons for the high heterogeneity in the WAB verbal score.Conclosion:Acupuncture combined with rTMS is more effective for post-stroke motor aphasia than acupuncture,r TMS or basic therapy alone.