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针刺治疗中风后吞咽困难的系统评价

Systematic Review on Acupuncture for Treatment of Dysphagia after Stroke.

作者信息

Ye Qiuping, Xie Yu, Shi Junheng, Xu Zhenhua, Ou Aihua, Xu Nenggui

机构信息

Guangzhou University of Chinese Medicine, Airport Road, Baiyun District, Guangdong, Guangzhou 510006, China.

Guangdong Provincial Hospital of Chinese Medicine, Yide Road, Yuexiu District, Guangdong, Guangzhou 510006, China.

出版信息

Evid Based Complement Alternat Med. 2017;2017:6421852. doi: 10.1155/2017/6421852. Epub 2017 Aug 9.

Abstract

OBJECTIVE

To assess the therapeutic efficacy of acupuncture for dysphagia after stroke.

METHODS

Seven electronic databases were searched from their inception until 31 September 2016. All randomized controlled trials (RCTs) incorporating acupuncture or acupuncture combined with other interventions for treatment of dysphagia after stroke were enrolled. Then they were extracted and assessed by two independent evaluators. Direct comparisons were conducted in RevMan 5.3.0 software.

RESULTS

6010 patients of 71 papers were included. The pooled analysis of efficacy rate of 58 studies indicated that acupuncture group was superior to the control group with moderate heterogeneity (RR = 1.17, 95% CI: 1.13 1.21, = 9.08, and < 0.00001); meta-analysis of the studies using blind method showed that the efficacy rate of acupuncture group was 3.01 times that of control group with no heterogeneity (RR = 3.01, 95% CI: 1.95 4.65, = 4.97, and < 0.00001). Only 13 studies mentioned the safety evaluation.

CONCLUSION

The result showed that the acupuncture group was better than control group in terms of efficacy rate of dysphagia after stroke. And the combining result of those researches using blind method was more strong in proof. Strict evaluation standard and high-quality RCT design are necessary for further exploration.

摘要

目的

评估针刺治疗中风后吞咽困难的疗效。

方法

检索七个电子数据库,检索时间从建库至2016年9月31日。纳入所有采用针刺或针刺联合其他干预措施治疗中风后吞咽困难的随机对照试验(RCT)。然后由两名独立评估者进行提取和评估。在RevMan 5.3.0软件中进行直接比较。

结果

纳入71篇论文的6010例患者。58项研究的有效率合并分析表明,针刺组优于对照组,异质性中等(RR = 1.17,95%CI:1.13 - 1.21,I² = 9.08,P < 0.00001);采用盲法的研究的Meta分析表明,针刺组的有效率是对照组的3.01倍,无异质性(RR = 3.01,95%CI:1.95 - 4.65,I² = 4.97,P < 0.00001)。仅13项研究提及安全性评估。

结论

结果表明,针刺组在中风后吞咽困难的有效率方面优于对照组。采用盲法的那些研究的合并结果证据更强。进一步探索需要严格的评估标准和高质量的RCT设计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/359c/5568619/6152e374deab/ECAM2017-6421852.001.jpg

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