Huang Jinke, Shi Yao, Qin Xiaohui, Shen Min, Wu Manli, Huang Yong
The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510120, China.
Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, China.
Evid Based Complement Alternat Med. 2020 Sep 26;2020:1560978. doi: 10.1155/2020/1560978. eCollection 2020.
Electroacupuncture (EA), an extension of acupuncture, which is based on traditional acupuncture combined with modern electrotherapy, is commonly used for poststroke dysphagia (PSD) in clinical treatment and research. However, there is still a lack of sufficient evidence to recommend the routine use of EA for PSD. The aim of this study was to assess the efficacy and safety of EA in the treatment of PSD.
Randomized controlled trials (RCTs) evaluating the effects of EA on PSD were identified through a comprehensive literature search of the PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Database, and VIP databases from their inception to July 2020. The quality assessment of the included trials was performed based on the guidance of the Cochrane Reviewers' Handbook, and meta-analysis (MA) was performed by using the RevMan 5.3 software.
Sixteen trials were identified, and these included 1,216 patients with PSD. The results demonstrated that EA in combination with swallowing rehabilitation training (SRT) was significantly superior to SRT alone with regard to effective rate (OR 5.40, 95% CI [3.78, 7.72], < 0.00001, water swallow test (WST) (MD -0.78, 95% CI [-1.07, -0.50], < 0.00001), the video fluoroscopic swallowing study (VFSS) (MD 1.47, 95% CI [1.11, 1.84], < 0.00001), the Ichiro Fujishima Rating Scale (IFRS) (MD 1.94, 95% CI [1.67, 2.22], < 0.00001), and the incidence of aspiration pneumonia (IAP) (OR 0.20, 95% CI [0.06, 0.61], =0.005).
The results showed that EA was better than the control treatment in terms of the effective rate, WST, VFSS, IFRS, and IAP of dysphagia after stroke. Strict evaluation standards and high-quality RCT designs are necessary for further exploration.
电针作为针灸的延伸，基于传统针灸并结合现代电疗法，在临床治疗和研究中常用于治疗中风后吞咽困难（PSD）。然而，仍缺乏足够证据推荐将电针常规用于PSD治疗。本研究旨在评估电针治疗PSD的疗效和安全性。
通过全面检索PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、中国生物医学数据库和维普数据库，从建库至2020年7月，识别评估电针对PSD影响的随机对照试验（RCT）。根据Cochrane系统评价员手册的指导对纳入试验进行质量评估，并使用RevMan 5.3软件进行荟萃分析（MA）。
共识别出16项试验，包括1216例PSD患者。结果表明，电针联合吞咽康复训练（SRT）在有效率（OR 5.40，95%CI[3.78，7.72]，P<0.00001）、饮水试验（WST）（MD -0.78，95%CI[-1.07，-0.50]，P<0.00001）、电视荧光吞咽造影检查（VFSS）（MD 1.47，95%CI[1.11，1.84]，P<0.00001）、藤岛一郎评级量表（IFRS）（MD 1.94，95%CI[1.67，2.22]，P<0.00001）以及吸入性肺炎发生率（IAP）（OR 0.20，95%CI[0.06，0.61]，P =0.005）方面均显著优于单纯SRT。
结果显示，在中风后吞咽困难的有效率、WST、VFSS、IFRS和IAP方面，电针优于对照治疗。进一步探索需要严格的评估标准和高质量的RCT设计。
