| Background Cerebral palsy is one of the major diseases, lead to children with neurological and physical disability, seriously affecting the quality of life of patients and imposing a heavy burden on families and society. Currently, the main therapies of cerebral palsy are rehabilitation training, hyperbaric oxygen therapy, drugs and surgical treatment. However, the mere physical rehabilitation and drug treatment is not so ideal. Surgical treatment of high risk and great wound, the complications after operation occurs sometime. Acupuncture treatment of cerebral palsy has well clinical and experimental study of foundation, a large number of clinical studies reported in the literature for its safety and efficacy. But, because of uneven quality research literature, clinical study design factors irrationality, therefore, the lack of evidence for efficacy and safety of acupuncture is still a problem.Objectives To collect home and abroad before the end of May2012all published and unpublished, acupuncture treatment of cerebral palsy randomized controlled trial (RCT) literature both in Chinese and English. Via systematic review evaluate the efficiency and safety, also the basis for acupuncture of cerebral palsy, and provide evidence-based medicine for the clinical application of acupuncture treatment for cerebral palsy.Materials and Methods Strict inclusion and exclusion criteria, comprehensive search Chinese Journal Full-text Database(CNKI), VIP Chinese Science and Technology Periodical Database, Wan Fang Database, Chinese Biomedical Database, The Cochrane Library(2012, Issue4),Medline, Pub Med, Current Controlled Trials(CCTR),EBSCO Database, High wire press. Hand searched from January to May2012Published in "Chinese Acupuncture","Acupuncture Research","Shanghai Journal of Acupuncture","Journal of Clinical Acupuncture","Journal of Liaoning Traditional Chinese Medicine","Journal of Traditional Chinese Medicine","Evidence based Medicine" and "New Medicine" and in http://www.who.int/en/, http://www.controlled-trials.com, http://www.clinicaltrials.gov and other network resources and Conference Literature Database (CMCC) and the gray literature database to supplement search. By two researchers independently met the inclusion criteria of randomized controlled trials, data extraction and quality assessment, if any differences through discussion or by a third researchers to solve. Finally, the research into the literature of the quality assessment and data synthesis. Using total effective rate, GMFM score, WeeFIM score and Gesell score as indicators of the efficacy of acupuncture treatment of Cerebral Palsy. Statistical analysis Provided by Cochrane Collaboration RevMans5.2.3software, count data, calculate the odds ratio(OR)or relative risk (Relative Risk, RR)and95%confidence interval (confidence interval, CI),measurement data, weighted mean difference(weighted mean difference, WMD)or standardized mean difference(standardized mean difference, SMD)and95%confidence interval.Results A total of516retrieved documents. Ultimately into22met the inclusion criteria of clinical trials in English and Chinese Patients were enrolled. The22included trials methodological quality was generally low, mainly in:random allocation scheme is imperfect, few trials use allocation concealment; the proper use of a small blind test; no sample size estimation; did not say withdrawal and exit the situation, without making the intention of the analysis; very small number of test subjects after the end of treatment were followed up, and several other aspects. Extracted data, the Meta-analysis or descriptive analysis:(1) Efficiency:Acupuncture in combination with rehabilitation training is better than only rehabilitation training [OR=3.48,95%CI=(2.52,4.79), Z=7.61,P<0.00001]; Acupuncture in combination with rehabilitation training is better than rehabilitation training in combination with sham acupuncture [OR=3.56,95%CI=(1.55,8.17), P=0.003]; Acupuncture is better than sham acupuncture[MD=1.86,95%CI=(1.38,2.34), P<0.00001];(2) GMFM score: the observation group is better than control group in improving the gross motor function [MD=3.27,95%CI=(1.31,5.23), P=0.001], sensitivity analysis consistent with the general trend;(3) Modify the Frenchay dysarthria assessment method:the observation group is better than control group in improving the language barrier [OR=3.15,95%CI=(1-40,7.12),Z=2.76, P=0.006];(4) Gesell score:the observation group is better than control group in improving the intelligence of children with cerebral palsy[OR=2.93,95%CI=(1.17,7.34),P=0.02].Conclusion Current evidence suggests that, in terms of total effective rate, observation group is better than that of control group, acupuncture curative effect affirmation; Acupuncture has the certain curative effect in improving gross motor function, the intelligence, independence and cognitive ability of children with cerebral palsy. Preliminary concluded that acupuncture treatment of cerebral palsy has well efficacy and safety. But because of poor quality literature, this result should be carefully treated. Further research Necessary to conduct high quality,large sample of RCT to further clarify the efficacy of acupuncture treatment of Cerebral Palsy and safety. |
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