徐丹，陶陶，张继荣，凌会敏.阳极经颅直流电刺激治疗脑梗死后失语症疗效的Meta分析[J].中华物理医学与康复杂志,2017,39(8):625-630
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| 阳极经颅直流电刺激治疗脑梗死后失语症疗效的Meta分析 |
| Anodal transcranial direct current stimulation can relieve aphasia among stroke survivors: A meta-analysis of randomized and controlled trials |
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| DOI： |
| 中文关键词: 阳极经颅直流电刺激 脑梗死 失语症 Meta分析 随机对照试验 |
| 英文关键词: Transcranial direct current stimulation Stroke Aphasia Meta-analyses |
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| 中文摘要: |
| 目的 应用Meta分析评价阳极经颅直流电刺激治疗脑梗死后失语症的疗效。 方法 利用计算机检索中国生物医学文献数据库、中国知网及万方数据库、维普数据库、PubMed、MEDLINE、EMbase及Cochrane Library，同时手工检索相关杂志和资料中关于阳极经颅直流电刺激治疗脑梗死后失语症的临床随机对照试验，截止日期为2016年11月。由2位研究者按照纳入和排除标准筛选文献、整理资料、提取数据、质量评价，并交叉核对，随后采用RevMan5.3软件进行Meta分析。 结果 共纳入文献7篇，包括101例患者，Meta分析结果显示试验组患者经阳极经颅直流电刺激后，其失语症评分较对照组明显改善，SMD＝0.50，95％CI为(0.09，0.90)，P=0.02<0.05，差异具有统计学意义。阳极经颅直流电刺激能显著提高卒中后失语症患者的图命名能力（P=0.03）。治疗过程中仅有11例患者出现轻微不良反应，但都在患者耐受范围内，不需特殊处理。 结论 阳极经颅直流电刺激对脑梗死后失语症患者的语言恢复具有显著疗效，并且还具有操作简单、安全性高等优点，是一种值得推广、应用的康复治疗技术。受纳入研究的文献数量及其他因素限制，本文结论还有待更多大样本、高质量临床随机对照试验加以验证，以期为临床应用阳极经颅直流电刺激提供参考资料。 |
| 英文摘要: |
| Objective To systematically review the efficacy of anodal transcranial direct current stimulation (A-tDCS) for relieving aphasia among stroke survivors. Methods The Chinese BioMedical Literature database, China National Knowledge Infrastructure, WanFang database, Chinese Scientific Journals full-text database, PubMed, Embase, MEDLINE and the Cochrane Library for clinical randomized and controlled trials were searched for reports about the use of A-tDCS in the treatment of aphasia after stroke. The resulting reports were retrieved manually and evaluated by two independent reviewers according to pre-set inclusion and exclusion criteria. The reports covered the period to November 2016. A meta-analysis was then conducted using RevMan software version 5.3. Results Seven studies covering 101 patients were selected for analysis. Meta-analysis showed that the average aphasia function score improved after A-tDCS significantly more than in the control group. Picture naming ability in stroke survivors with aphasia showed particular improvement. Only 11 patients in the 7 studies presented light adverse effects from A-tDCS, always within the patients′ tolerance range. Conclusion A-tDCS can significantly improve the speech of patients with aphasia after cerebral infarction. It is safe and easy to administer and is a rehabilitation technology worth popularizing and applying. Considering the limited number of articles, the conclusion remains to be further verified with randomized clinical trials of higher quality and a larger sample. |
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