Efficacy And Safety Of Acupuncture Combined With Bobath In The Treatment Of Post-Stroke Spastic Paralysis:A Systematic Review And Meta-Analysis

ObjectiveTo systematically review the efficacy and safety of acupuncture combined bobath in the treatment of Post-Stroke Spastic Paralysis.MethodsPubMed,Cochrane Library,Web of Science,CNKI,VIP,CBM and WanFang Data databases were searched to collect randomized controlled trials(RCTs)on acupuncture combined bobath in the treatment of Post-Stroke Spastic Paralysis from inception to December 31th,2018.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies according to the Cochrane Risk of Bias Tool,Meta-analysis was performed by RevMan 5.3 software.ResultsFourteenth RCTs involving 1183 patients were included.The results of meta-analysis showed that,①the clinical effective rate:compared with bobath alone group,the clinical effective rate in acupuncture combined bobath group was higher(RR=1.30,95%CI(1.17,1.45),P<0.00001);② FMA score in the acupuncture combined bobath group was higher than that in the acupuncture or bobath alone group(MDUpper limb=7.19,95%CI(5.77,8.62),P<0.00001;MDLower limb=4.29,95%CI(2.54,6.04),P<0.00001);③ Barthel index in the acupuncture combined bobath group was higher than that in the bobath alone group(MD=9.60,95%CI(7.34,11.86),P<0.00001);④CSI score in the acupuncture combined bobath group was better than that in the bobath alone group(WMD=-1.30,95%CI(-1.79,-0.82),P<0.00001);⑤NDS score in the acupuncture combined bobath group was better than that in the bobath alone group(WMD=-5.63,95%CI(-7.74,-3.51),P<0.00001).ConclusionAcupuncture combined bobath was better than acupuncture or bobath alone in remission of Post-Stroke Spastic Paralysis,it could improve the ability of living and motor function of patient better.Due to the limited quality and quantity of the included studies,it is necessary to perform more high quality RCTs to verify above conclusions.