College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
Intensive Care Unit, Xiangya Hospital Central South University, Changsha, Hunan, China.
Biotechnol Genet Eng Rev. 2024 Apr;40(1):436-453. doi: 10.1080/02648725.2023.2184044. Epub 2023 Mar 26.
To compare the effects of various therapies in patients with post-stroke dysphagia.
We searched databases between January 1980 and 2022.
Randomized controlled trials (RCTs) on therapy for dysphagia after stroke.
The outcomes were improvement in dysphagia, case fatality, and chest infection or pneumonia, reported as OR (odd ratio), 95% CrI (confidence interval), and SUCRA (the surface under the cumulative ranking curve analysis) score. Forty-two randomized controlled trials (2,993 patients, seven therapies, and one control) were included. In the improvement of dysphagia analysis, the following therapies were superior to the control: Acupuncture, behavioral interventions, drug therapy, neuromuscular electrical stimulation (NMES) and pharyngeal electrical stimulation (PES). In the case fatality analysis, OR and 95% CrI indicated none of the therapies were superior to the control. In the chest infection or pneumonia analysis, OR values showed that no therapy was superior to the control. Our Network Meta-analysis suggests that commonly used therapies for dysphagia after stroke have equal efficacies.
比较不同疗法对脑卒中后吞咽困难患者的疗效。
我们检索了 1980 年 1 月至 2022 年的数据库。
脑卒中后吞咽困难治疗的随机对照试验(RCT)。
结局为吞咽困难改善、病死率以及胸部感染或肺炎,报告为 OR(比值比)、95%CrI(置信区间)和 SUCRA(累积排序曲线分析下的面积)评分。共纳入 42 项 RCT(2993 例患者,7 种疗法和 1 种对照)。在吞咽困难改善分析中,以下疗法优于对照组:针刺、行为干预、药物治疗、神经肌肉电刺激(NMES)和咽部电刺激(PES)。在病死率分析中,OR 和 95%CrI 表明没有一种疗法优于对照组。在胸部感染或肺炎分析中,OR 值表明没有一种疗法优于对照组。我们的网状 Meta 分析表明,脑卒中后吞咽困难的常用疗法疗效相当。