重复经颅磁刺激治疗卒中后单侧空间忽略的Meta分析

发布时间：2018-05-27 07:08

本文选题：脑卒中 + 单侧空间忽略　；参考：《中国康复理论与实践》2017年03期

【摘要】：目的系统评价重复经颅磁刺激(rTMS)对脑卒中患者单侧空间忽略的治疗效果。方法检索Pub Med、OVID、Embase、Cochrane Library、中国知识资源总库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库中关于rTMS改善脑卒中患者单侧空间忽略的随机对照试验,搜索时限从建库至2016年7月。由两名研究者按纳入和排除标准筛选文献并提取有效数据,进行质量评价。采用Rev Man 5.3软件和GRADE profiler 3.6软件对最终纳入的文献数据进行统计学分析。结果最终纳入12篇文献,共353例受试者。按照治疗组刺激频率分为低频rTMS组、高频rTMS组和持续短阵快速脉冲经颅磁刺激(c TBS)组分别进行分析。共考察3个结局指标:二等分线段试验(LBT)、星形删除试验(SCT)、Albert线段划消试验(AT)。结果显示,与对照组相比,接受rTMS治疗的患者,在3项结局指标上均有较好表现,不同刺激频率均显示较好疗效(低频rTMS:SMD=-1.21,95%CI-2.17~-0.25。高频rTMS:SMD=-2.56,95%CI-3.54~-1.58。c TBS:SMD=-2.51,95%CI-3.66~-1.36)。结论 rTMS能改善脑卒中患者单侧空间忽略。
[Abstract]:Objective to evaluate the efficacy of repetitive transcranial magnetic stimulation (RTMS) in the treatment of unilateral spatial neglect in stroke patients. Methods A randomized controlled trial of rTMS to improve unilateral spatial neglect in stroke patients was searched in Pub MedOVIDE Embase Cochrane Library, China knowledge Resources General Library, Weipu Chinese Journal of Science and Technology full text database and Wanfang database. The search time was from the establishment of the database to July 2016. According to the inclusion and exclusion criteria, two researchers sifted the literature and extracted valid data for quality evaluation. Rev Man 5.3 software and GRADE profiler 3.6 software were used to analyze the literature data. Results A total of 353 subjects were included in 12 articles. According to the frequency of stimulation, the treatment group was divided into three groups: low frequency rTMS group, high frequency rTMS group and continuous short array fast pulse transcranial magnetic stimulation group. Three outcome indexes were examined: second line segment test (LBTT), star deletion test (SCT) and Albert segment elimination test (ATT). The results showed that compared with the control group, the patients treated with rTMS showed better performance in all three outcome indexes, and the different stimulation frequencies showed better results (low frequency RMS: SMD-1.21 95 CI-2.17 ~ 0.25). High frequency RMS: SMD-2.5695, CI-3.54 -1.58.c TBS: SMD-2.51C 95 CI-3.66C. Conclusion rTMS can improve unilateral spatial neglect in stroke patients.
【作者单位】：南京中医药大学第二临床医学院;海南省农垦总医院康复治疗中心;
【分类号】：R743.3

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