Speech Pathology, LaTrobe University, Melbourne, Victoria, Australia.
Speech Pathology Department, The Alfred, Melbourne, Victoria, Australia.
Clin Exp Allergy. 2022 Mar;52(3):387-404. doi: 10.1111/cea.14036. Epub 2021 Nov 4.
To determine whether treatment effectiveness can be established for a range of vocal cord dysfunction (VCD) interventions in adolescents and adults.
A systematic review of the literature and risk of bias appraisal was completed using the Joanna Briggs Institute Critical Appraisal Tools. Data were qualitatively synthesized in the broad intervention groups of glottic airway and respiratory retraining, pharmacological therapies, airway device therapies and psychological therapies.
Nine electronic databases, two clinical trial registries and the grey literature were searched from inception to September 2021 for articles on VCD interventions or equivalent terms.
Studies were included if they were randomized controlled trials, non-randomized controlled trials, quasi-experimental pre- and post-test studies and within-subject repeated measure designs, participants were 13 years or older, VCD was diagnosed using laryngoscopy or CT larynx, VCD intervention was provided and outcome measures reported on VCD symptoms.
The search yielded no randomized controlled trials. There were 17 quasi-experimental studies that met the eligibility criteria, and these studies reported on glottic airway and respiratory retraining, botulinum toxin injections, inspiratory muscle strength training and amitriptyline; all were associated with VCD symptom reduction. In addition, 2 within-subject repeated measure studies reported inspiratory muscle strength training and respiratory retraining to be effective in reducing symptoms in participants with exertional VCD. The included studies were reported in full-text publications (11) and conference proceedings (8). There was a high risk of bias and low quality of evidence across all intervention areas.
Glottic airway and respiratory retraining, botulinum toxin injections, low-dose amitriptyline and inspiratory muscle strength training devices have been associated with symptom reduction in adults and adolescents with vocal cord dysfunction. Limited objective data exist to support the effectiveness of these interventions, and robust controlled trials are needed in this area. Systematic Review Registration: CRD42018092274 (PROSPERO).
确定一系列声带功能障碍（VCD）干预措施在青少年和成人中的治疗效果是否成立。
使用 Joanna Briggs 研究所批判性评估工具对文献进行系统回顾和风险偏倚评估。数据在广泛的干预组中进行定性综合，包括声门上气道和呼吸训练、药理学治疗、气道设备治疗和心理治疗。
从成立到 2021 年 9 月，在九个电子数据库、两个临床试验注册处和灰色文献中搜索了关于 VCD 干预或等效术语的文章。
如果研究是随机对照试验、非随机对照试验、准实验前后测试研究和自身重复测量设计，参与者年龄在 13 岁或以上，VCD 通过喉镜或 CT 喉诊断，提供 VCD 干预措施，并报告 VCD 症状的结果测量，则将其纳入研究。
搜索未发现随机对照试验。有 17 项符合入选标准的准实验研究，这些研究报告了声门上气道和呼吸训练、肉毒毒素注射、吸气肌力量训练和阿米替林的研究结果，所有这些都与 VCD 症状减轻有关。此外，2 项自身重复测量研究报告吸气肌力量训练和呼吸训练对运动性 VCD 患者症状减轻有效。纳入的研究均在全文出版物（11 篇）和会议论文集（8 篇）中报告。所有干预领域均存在高偏倚风险和低质量证据。
声门上气道和呼吸训练、肉毒毒素注射、低剂量阿米替林和吸气肌力量训练设备与成人和青少年声带功能障碍患者的症状减轻相关。目前有限的客观数据支持这些干预措施的有效性，因此该领域需要进行强有力的对照试验。系统评价注册：CRD42018092274（PROSPERO）。
