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非药物干预治疗脑卒中后吞咽障碍的疗效比较:系统评价和贝叶斯网状 Meta 分析。

Comparison of efficacy of non-pharmacological intervention for post-stroke dysphagia: a systematic review and Bayesian network meta-analysis.

机构信息

The First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, China.

Anhui Integrated Traditional Chinese and Western Medicine Hospital, Hefei, China.

出版信息

BMC Neurosci. 2023 Oct 16;24(1):53. doi: 10.1186/s12868-023-00825-0.

Abstract

Increasingly, non-pharmacological interventions are being identified and applied to post-stroke dysphagia. Nevertheless, there is insufficient evidence to assess which type of interventions are more effective. In this study, the randomized controlled trials of non-pharmacological interventions on post-stroke dysphagia were retrieved from the relevant databases. Including 96 studies and 12 non-drug treatments. Then, and the network meta-analysis is carried out by statistical software. The results show: In the aspects of videofluoroscopic swallowing study (VFSS), Standardized Swallowing Assessment (SSA), swallowing-quality of life (SWAL-QOL), Water swallow test (WST); Acupuncture + electrotherapy + rehabilitation training, acupuncture + rehabilitation training + massage, electrotherapy + rehabilitation training, acupuncture + electrotherapy + rehabilitation training, electrotherapy, acupuncture + rehabilitation training + acupoints sticking application have significant effects in post-stroke dysphagia. Compared with other interventions, they have more advantages in improving the above indicators. A substantial number of high-quality randomized clinical trials are still necessary in the prospective to validate the therapeutic effectiveness of non-pharmacological interventions in post-stroke dysphagia and the results of this Bayesian network meta-analysis.

摘要

越来越多的非药物干预措施被确定并应用于脑卒中后吞咽困难。然而,目前还没有足够的证据来评估哪种干预措施更有效。在这项研究中,从相关数据库中检索到了针对脑卒中后吞咽困难的非药物干预的随机对照试验。共纳入 96 项研究和 12 种非药物治疗方法。然后,通过统计软件进行网络荟萃分析。结果表明:在录像吞咽研究(VFSS)、标准化吞咽评估(SSA)、吞咽生活质量(SWAL-QOL)、饮水吞咽试验(WST)方面;针刺+电疗+康复训练、针刺+康复训练+按摩、电疗+康复训练、针刺+电疗+康复训练、电疗、针刺+康复训练+穴位贴敷应用在脑卒中后吞咽困难中均有显著效果。与其他干预措施相比,它们在改善上述指标方面具有更大的优势。需要进行大量高质量的随机临床试验,以验证非药物干预措施在脑卒中后吞咽困难中的治疗效果,以及本贝叶斯网络荟萃分析的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faec/10578008/1e4d86c9bbbc/12868_2023_825_Fig1_HTML.jpg

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