本文選題：綜合康復(fù)療法 + 肩手綜合征��； 參考：《北京體育大學(xué)》2014年碩士論文

【摘要】：目的：肩手綜合征是腦卒中后常見(jiàn)的并發(fā)癥之一。本病常用的治療手段為藥物。綜合康復(fù)療法具有緩解手浮腫、皮膚溫度升高的作用,可以從局部和整體治療。此方法無(wú)副作用且療效顯著,因此被稱為綠色療法。對(duì)大量的文獻(xiàn)進(jìn)行檢索發(fā)現(xiàn),現(xiàn)代循證醫(yī)學(xué)在研究問(wèn)題上使用的較少,為了對(duì)綜合康復(fù)療法治療肩手綜合征的療效進(jìn)行分析及評(píng)價(jià),本研究采用Meta分析法對(duì)綜合康復(fù)療法治療本病臨床文獻(xiàn)做回顧性分析,以達(dá)到較為客觀的評(píng)價(jià)綜合康復(fù)療法治療本病的臨床療效且為今后使用綜合康復(fù)療法治療本病提供可靠的依據(jù)。 結(jié)果：本文通過(guò)對(duì)1990年-2012年在國(guó)內(nèi)各類(lèi)期刊雜志中發(fā)表的綜合康復(fù)療法治療肩手綜合征臨床RCT(隨機(jī)對(duì)照試驗(yàn))進(jìn)行研究,在對(duì)大量的文獻(xiàn)篩選過(guò)程中使用了Jadad評(píng)分,分析使用的是Review Manager4.2處理軟件。對(duì)符合本研究文獻(xiàn)要求的17篇文獻(xiàn)進(jìn)行Meta分析,在經(jīng)過(guò)JADAD評(píng)分后發(fā)現(xiàn),國(guó)內(nèi)研究者沒(méi)有嚴(yán)格的按照Cochrane協(xié)作組織給出的文獻(xiàn)納入的標(biāo)準(zhǔn)來(lái)對(duì)文獻(xiàn)進(jìn)行篩選,因此,今后在對(duì)納入文獻(xiàn)的方面要嚴(yán)格的按照Cochrane協(xié)作組織給出的標(biāo)準(zhǔn)納入文獻(xiàn)。根據(jù)干預(yù)措施不同,可以分為三組來(lái)進(jìn)行分析,所用文獻(xiàn)15篇,分析結(jié)果顯示：1、綜合康復(fù)療法結(jié)合常規(guī)的藥物治療療效優(yōu)勢(shì)比(OR)值為8.60,95%的置信區(qū)間為[4.77,15.51],P0.05,差異有統(tǒng)計(jì)學(xué)意義。2、針灸結(jié)合常規(guī)康復(fù)訓(xùn)練療效優(yōu)勢(shì)比值(OR)為8.83,95%的置信區(qū)間為[5.93,13.14],P0.05差異有統(tǒng)計(jì)學(xué)意義3、綜合康復(fù)療法結(jié)合常規(guī)康復(fù)訓(xùn)練療效優(yōu)勢(shì)比值(OR)4.65,95%的置信區(qū)間為[2.58,8.40],P0.05差異有統(tǒng)計(jì)學(xué)意義。由于另外兩篇的干預(yù)措施不同,故不作Meta分析。 結(jié)論：綜合康復(fù)療法治療肩手綜合征是有效的；綜合康復(fù)療法與常規(guī)藥物治療結(jié)合的療效優(yōu)于單純使用常規(guī)藥物治療、綜合康復(fù)療法與常規(guī)康復(fù)訓(xùn)練結(jié)合優(yōu)于單純使用康復(fù)訓(xùn)練、針灸療法與常規(guī)康復(fù)訓(xùn)練的結(jié)合優(yōu)于單純使用常規(guī)康復(fù)訓(xùn)練。綜合康復(fù)訓(xùn)練仍然是需要大樣本、多中心、高標(biāo)準(zhǔn)的臨床隨機(jī)對(duì)照試驗(yàn)以補(bǔ)充說(shuō)明。
[Abstract]:Objective: shoulder-hand syndrome is one of the common complications after stroke. The commonly used treatment for this disease is medicine. Comprehensive rehabilitation therapy has the effect of relieving hand swelling and increasing skin temperature, and can be treated locally and as a whole. This method has no side effects and is effective, so it is called green therapy. In order to analyze and evaluate the curative effect of comprehensive rehabilitation therapy on shoulder-hand syndrome, a large number of literatures have been searched and found that modern evidence-based medicine is less used in research. In this study, Meta analysis was used to review the clinical literature of comprehensive rehabilitation therapy for this disease. Objective to evaluate the clinical efficacy of comprehensive rehabilitation therapy and to provide reliable basis for the future use of comprehensive rehabilitation therapy for the treatment of this disease. Results: the clinical RCT (randomized controlled trial) of comprehensive rehabilitation therapy for shoulder and hand syndrome, published in various domestic journals from 1990 to 2012, was studied, and Jadad scores were used in the screening of a large number of literatures. The analysis uses Review Manager4.2 processing software. Through Meta analysis of 17 articles that meet the requirements of this study, it is found that the domestic researchers did not screen the literature strictly according to the criteria of literature inclusion given by the Cochrane collaboration organization after the JADAD score. In the future, we should strictly follow the standards given by the Cochrane collaboration organization to include the literature. According to the intervention measures, we can divide them into three groups to analyze them. The results showed that the odds ratio of comprehensive rehabilitation therapy combined with routine drug therapy was 8.6095% (P 0.05), the difference was statistically significant (P < 0.01), and the odds ratio of acupuncture and routine rehabilitation training was 8.83% (P < 0.05). There was significant difference (P < 0.05) between two groups (P < 0.05). There was significant difference between two groups (P < 0.05). The confidence interval of comprehensive rehabilitation therapy combined with conventional rehabilitation training was 4.6595% (P < 0.05). Meta analysis was not performed because of the different interventions in the other two articles. Conclusion: comprehensive rehabilitation therapy is effective in the treatment of shoulder-hand syndrome, and the combination of comprehensive rehabilitation therapy and routine drug therapy is better than that of simple conventional drug therapy. The combination of comprehensive rehabilitation therapy and routine rehabilitation training is better than that of simple use of rehabilitation training, and the combination of acupuncture therapy and routine rehabilitation training is better than that of simple routine rehabilitation training. Comprehensive rehabilitation training continues to require large, multicenter, high-standard randomized controlled trials to supplement the description.
【學(xué)位授予單位】：北京體育大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.3

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