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电针治疗中风后吞咽困难疗效与安全性的系统评价和Meta分析

Systematic review and meta-analysis of the efficacy and safety of electroacupuncture for poststroke dysphagia.

作者信息

Li Xuezheng, Lu Lijun, Fu Xuefeng, Li Hao, Yang Wen, Guo Hua, Guo Kaifeng, Huang Zhen

机构信息

Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, Guangdong, China.

Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, Guangzhou Guangdong, China.

出版信息

Front Neurol. 2023 Dec 6;14:1270624. doi: 10.3389/fneur.2023.1270624. eCollection 2023.


DOI:10.3389/fneur.2023.1270624
PMID:38125830
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10731355/
Abstract

INTRODUCTION: Optimal treatment strategies for post-stroke dysphagia (PSD) remain to be explored. Electroacupuncture (EA) has attracted widespread attention due to its simplicity, cheapness, and safety. However, the efficacy of EA in the treatment of PSD lacks high-level evidence-based medical support. This study aimed to systematically evaluate the clinical value of EA in the treatment of PSD. METHODS: A total of seven databases were searched for relevant literature. All randomized controlled trials (RCTs) on EA alone or EA combined with other interventions for the treatment of PSD were assessed using the modified Jadad scale. The studies with a score of ≥4 were included. The quality of the included studies was then assessed using the Cochrane Collaboration's tool. The meta-analysis was performed using Rev. Man 5.3 software. RESULTS: Twelve studies involving 1,358 patients were included in the meta-analysis. Meta-analysis results showed that the EA group was superior to the control group in terms of clinical response rate (OR = 2.63, 95% CI = 1.97 to 3.53) and videofluoroscopic swallowing study (VFSS) score (MD = 0.73, 95% CI = 0.29 to 1.16). There was no significant difference between the two groups in the standardized swallowing assessment (SSA) score (MD = -3.11, 95% CI = -6.45 to 0.23), Rosenbek penetration-aspiration scale (PAS) score (MD = -0.68, 95% CI = -2.78 to 1.41), Swallowing Quality of Life (SWAL-QOL) score (MD = 13.24, 95% CI = -7.74 to 34.21), or incidence of adverse events (OR = 1.58, 95% CI = 0.73 to 3.38). CONCLUSION: This study shows that EA combined with conventional treatment or other interventions can significantly improve the clinical response rate and VFSS score in patients with PSD without increasing adverse reactions.: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396840.

摘要

引言:中风后吞咽困难(PSD)的最佳治疗策略仍有待探索。电针(EA)因其简便、价廉和安全而受到广泛关注。然而,电针治疗PSD的疗效缺乏高水平循证医学支持。本研究旨在系统评价电针治疗PSD的临床价值。 方法:检索七个数据库中的相关文献。使用改良的Jadad量表评估所有关于单独电针或电针联合其他干预措施治疗PSD的随机对照试验(RCT)。纳入评分≥4分的研究。然后使用Cochrane协作网工具评估纳入研究的质量。使用Rev. Man 5.3软件进行荟萃分析。 结果:荟萃分析纳入了12项研究,共1358例患者。荟萃分析结果显示,电针组在临床有效率(OR = 2.63,95%CI = 1.97至3.53)和电视荧光吞咽造影检查(VFSS)评分(MD = 0.73,95%CI = 0.29至1.16)方面优于对照组。两组在标准吞咽评估(SSA)评分(MD = -3.11,95%CI = -6.45至0.23)、罗森贝克渗透-误吸量表(PAS)评分(MD = -0.68,95%CI = -2.78至1.41)、吞咽生活质量(SWAL-QOL)评分(MD = 13.24,95%CI = -7.74至34.21)或不良事件发生率(OR = 1.58,95%CI = 0.73至3.38)方面无显著差异。 结论:本研究表明,电针联合传统治疗或其他干预措施可显著提高PSD患者的临床有效率和VFSS评分,且不增加不良反应。:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396840

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a36f/10731355/6d00d85464c2/fneur-14-1270624-g010.jpg
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引用本文的文献

[1]
Sensory Afferent Neural Circuits Mediate Electroacupuncture to Improve Swallowing Function in a Post-Stroke Dysphagia Mouse Model.

CNS Neurosci Ther. 2025-7

[2]
Current state of research on acupuncture for the treatment of post-stroke dysphagia: a scoping review.

Front Neurosci. 2024-8-15

本文引用的文献

[1]
Role of TRPV1 in electroacupuncture-mediated signal to the primary sensory cortex during regulation of the swallowing function.

CNS Neurosci Ther. 2024-3

[2]
Participation of the nucleus tractus solitarius in the therapeutic effect of electroacupuncture on post-stroke dysphagia through the primary motor cortex.

CNS Neurosci Ther. 2024-3

[3]
Electroacupuncture improves swallowing function in a post-stroke dysphagia mouse model by activating the motor cortex inputs to the nucleus tractus solitarii through the parabrachial nuclei.

Nat Commun. 2023-2-13

[4]
The Effects of Adding Di-Tan Decoction (DTD) and/or Electroacupuncture (EA) to Standard Swallowing Rehabilitation Training (SRT) for Improving Poststroke Dysphagia (PSD): A Pilot, Single-Centred, Randomized Trial.

Evid Based Complement Alternat Med. 2022-12-8

[5]
Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis.

BMC Geriatr. 2022-5-13

[6]
Excitatory neurons in paraventricular hypothalamus contributed to the mechanism underlying acupuncture regulating the swallowing function.

Sci Rep. 2022-4-6

[7]
A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study.

Dysphagia. 2022-12

[8]
Clinical study on swallowing function of brainstem stroke by tDCS.

Neurol Sci. 2022-1

[9]
[Clinical effect of Liyan Tongqiao acupuncture in treatment of post-stroke dysphagia: an analysis based on diffusion tensor imaging].

Zhen Ci Yan Jiu. 2020-12-25

[10]
Clinical Effects and Safety of Electroacupuncture for the Treatment of Poststroke Dysphagia: A Comprehensive Systematic Review and Meta-Analysis.

Evid Based Complement Alternat Med. 2020-9-26

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