Heilongjiang University of Chinese Medicine, Harbin, China.
Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.
Medicine (Baltimore). 2023 Nov 24;102(47):e36160. doi: 10.1097/MD.0000000000036160.
The aim of this systematic review is to evaluate the effectiveness of combining acupuncture with speech rehabilitation training, compared to acupuncture alone or speech rehabilitation training alone, in the treatment of post-stroke aphasia.
To gather data for this study, we searched 6 databases: PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang Data, and Chongqing VIP Database. We included clinical randomized controlled trials on acupuncture combined with rehabilitation training for post-stroke aphasia published between January 1, 2011 and October 8, 2023. Two researchers independently screened the literature, evaluated its quality, and extracted the data using Stata 15.1 SE and RevMan 5.4 software. We conducted a meta-analysis using the random effects model, and expressed dichotomous variables as odds ratios (OR) with 95% confidence intervals (CIs) and continuous variables as weighted mean differences (WMD) with 95% confidence intervals. Specifically, the odds of improvement were significantly higher in the combination group (OR = 3.89, 95% CI = [2.62, 5.78]). Improvements were also seen in several language functions, including expression (WMD = 5.14, 95% CI = [3.87, 6.41]), understanding (WMD = 9.16, 95% CI = [5.20, 13.12]), retelling (WMD = 11.35, 95% CI = [8.70, 14.00]), naming (WMD = 11.36, 95% CI = [8.12, 14.61] ), reading (WMD = 9.20, 95% CI = [4.87, 13.52]), writing (WMD = 5.65, 95% CI = [3.04, 8.26]), and reading aloud (WMD = 7.45, 95% CI = [3.12, 11.78]). Scores on the Chinese Aphasia Complete Test Scale, Western Aphasia Complete Test Scale, and China Rehabilitation Research Center Aphasia Check Scale were also significantly higher in the combination group, with improvements of 7.89, 9.89, and 9.27, respectively.
A total of 16 clinical randomized controlled trials, including 1258 patients, were included in this meta-analysis. The results showed that compared to simple rehabilitation training or acupuncture treatment alone, the combination of acupuncture and language rehabilitation training was more effective in improving clinical outcomes for patients with post-stroke aphasia.
The results of this meta-analysis indicate that acupuncture combined with language rehabilitation training can effectively improve the language function of post-stroke aphasia patients and increase clinical effectiveness. However, further research is needed to confirm these findings and provide a more reliable evidence-based basis for clinical practice. In particular, additional studies with large sample sizes, high quality, and more specific and standardized outcome measures are needed to strengthen the evidence. The limited quantity and quality of the current studies may affect the generalizability of the results.
本系统评价旨在评估与单独针灸或言语康复训练相比，针灸联合言语康复训练治疗脑卒中后失语症的有效性。
为了收集本研究的数据，我们检索了 6 个数据库：PubMed、Cochrane Library、Embase、中国知网、万方数据和重庆维普数据库。我们纳入了 2011 年 1 月 1 日至 2023 年 10 月 8 日发表的关于针灸联合康复训练治疗脑卒中后失语症的临床随机对照试验。两名研究人员独立筛选文献、评估质量，并使用 Stata 15.1 SE 和 RevMan 5.4 软件提取数据。我们使用随机效应模型进行荟萃分析，用比值比（OR）和 95%置信区间（CI）表示二分类变量，用加权均数差值（WMD）和 95%CI 表示连续性变量。具体来说，联合组的改善概率明显更高（OR=3.89，95%CI=[2.62, 5.78]）。几项语言功能也有所改善，包括表达（WMD=5.14，95%CI=[3.87, 6.41]）、理解（WMD=9.16，95%CI=[5.20, 13.12]）、复述（WMD=11.35，95%CI=[8.70, 14.00]）、命名（WMD=11.36，95%CI=[8.12, 14.61]）、阅读（WMD=9.20，95%CI=[4.87, 13.52]）、书写（WMD=5.65，95%CI=[3.04, 8.26]）和朗读（WMD=7.45，95%CI=[3.12, 11.78]）。汉语失语症检查量表、西方失语症成套测验和中国康复研究中心失语症检查量表的评分也明显更高，分别为 7.89、9.89 和 9.27。
本荟萃分析共纳入 16 项临床随机对照试验，共 1258 例患者。结果表明，与单纯康复训练或针灸治疗相比，针灸联合语言康复训练在改善脑卒中后失语症患者的临床结局方面更有效。
这项荟萃分析的结果表明，针灸联合语言康复训练可有效改善脑卒中后失语症患者的语言功能，提高临床疗效。但是，还需要进一步的研究来证实这些发现，并为临床实践提供更可靠的基于证据的基础。特别是需要更多大样本量、高质量以及更具体和标准化的结局指标的研究，以加强证据的可信度。目前研究数量和质量的局限性可能会影响结果的普遍性。
