Park Young-Jae, Lee Jin-Moo
Department of Biofunctional Medicine and Diagnostics, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
Department of Diagnosis and Biofunctional Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2020 Sep 14;2020:4981945. doi: 10.1155/2020/4981945. eCollection 2020.
This study aimed to evaluate the effect of acupuncture intervention and manipulation types on poststroke dysarthria. Electronic database, including PubMed, CENTRAL, Scopus, RISS, and CNKI, were searched for randomized controlled trials (RCT), treating dysarthria using acupuncture, speech-language therapy (SLT), and general management (GM), published before April 2019. The number, distribution, intensity, depth, and repetition of acupuncture and bleeding therapy on the sublingual veins were considered as manipulation types. Risk of bias of the included trials was evaluated, and their efficacy was assessed using risk ratio (RR) and the standard mean differences in the Frenchay Dysarthria Assessment and Speech Function Grading, with 95% confidence intervals (CIs).Fifteen RCT trials involving 1453 patients were isolated. Electroacupuncture plus SLT and manual acupuncture plus SLT were more effective than SLT only, respectively (RR = 1.520, 95% CI [1.183-1.952], RR = 1.380, 95% CI [1.281-1.488]). The clinical efficacy of acupuncture plus GM was higher than that of GM alone (RR = 1.165, 95% CI [1.050-1.293]). Meta-ANOVA showed that none of the manipulation types increased the clinical efficacy of acupuncture on dysarthria. The methodological quality was low. In conclusion, our study suggests that the effect of acupuncture on poststroke dysarthria may be maximized when manual acupuncture or electroacupuncture is combined with SLT, irrespective of manipulation types.
本研究旨在评估针刺干预及手法类型对脑卒中后构音障碍的影响。检索了包括PubMed、CENTRAL、Scopus、RISS和中国知网在内的电子数据库，查找2019年4月之前发表的使用针刺、言语语言治疗（SLT）和综合管理（GM）治疗构音障碍的随机对照试验（RCT）。将针刺及舌下静脉放血疗法的次数、分布、强度、深度和重复情况视为手法类型。评估纳入试验的偏倚风险，并使用风险比（RR）以及Frenchay构音障碍评估和言语功能分级中的标准均数差值，并结合95%置信区间（CI）来评估其疗效。筛选出15项涉及1453例患者的RCT试验。电针联合SLT和手针联合SLT分别比单纯SLT更有效（RR = 1.520，95%CI [1.183 - 1.952]，RR = 1.380，95%CI [1.281 - 1.488]）。针刺联合GM的临床疗效高于单纯GM（RR = 1.165，95%CI [1.050 - 1.293]）。Meta方差分析显示，没有一种手法类型能提高针刺治疗构音障碍的临床疗效。方法学质量较低。总之，我们的研究表明，无论手法类型如何，手针或电针与SLT联合使用时，针刺对脑卒中后构音障碍的效果可能最佳。
