醒脑开窍针刺法治疗中风后吞咽障的系统评价与Meta分析*
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(1.云南中医药大学,云南 昆明 650500;2.云南省中医医院, 云南 昆明 650021; 3.宣威市中医医院,云南 宣威 655400;4.盘龙区人民医院,云南 昆明 650200)

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R246.6

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收稿日期: 2019 - 05- 22
* 基金项目: 云南省卫生科技计划项目(2018NS0033,2016NS166)
第一作者简介: 徐连杰(1994-),男,在读硕士研究生,研究方向:针灸防治脑病的临床与机理研究。
△通信作者: 张霞辉,E-mail:754258082@qq.com


Consciousness Restoring for Resuscitation Acupuncture Therapy for Dysphagia after Stroke: A Systematic Review and Meta-Analysis
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(1. Yunnan University of Chinese Medicine, Kunming 650500,China; 2.Yunnan Provincial Hospital of Traditional Chinese Medicine , Kunming 650021,China; 3. Xuanwei Hospital of Traditional Chinese Medicine,Xuanwei 655400 ,China; 4. Panlong District People's Hospital, Kunming, 650200,China)

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    摘要:

    目的系统评价醒脑开窍针刺法治疗中风后吞咽障碍的临床疗效,为醒脑开窍针刺法治疗中风后吞咽障碍提供循证医学证据。方法 计算机检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(WANFANG )、维普期刊全文数据库(VIP)从建库以来至2018年12月发表的关于醒脑开窍针刺法治疗中风后吞咽障碍的临床随机对照试验(RCT)。由2名研究人员,依据纳入标准与排除标准,筛选文献,提取资料,按照 Cochrane 手册 5.1.0 标准对纳入的研究进行偏倚风险评估,利用Jadad 量表进行方法学质量评价,采用Review Manage5. 3 软件进行统计分析。结果 最终纳入符合标准的文献22篇,累积患者1 998例。Meta分析结果示,醒脑开窍针刺法或醒脑开窍针刺法联合其他辅助疗法治疗优于对照组,在总有效率、痊愈率、洼田饮水试验(WST)、藤岛一郎吞咽评分(FIRS)、标准吞咽功能评分(SSA)指标比较,差异比较具有统计学意义。结论 醒脑开窍针刺法治疗中风后吞咽障碍具有良好的疗效,但因纳入文献数量有限,质量偏低,仍需更多高质量的RCT试验来验证醒脑开窍针刺法治疗中风后吞咽障碍的临床疗效。

    Abstract:

    Objective To evaluate the efficacy of consciousness restoring for resuscitation acupuncture therapy in the treatment of dysphagia after stroke, and to provide evidence-based medical evidence for the treatment of dysphagia after stroke by consciousness restoring for resuscitation acupuncture therapy. Methods Searching the China National Knowledge Infrastructure(CNKI), the China Biomedical Medicine(CBM), the Wanfang Data Knowledge Service Platform(WANFANG ), and the Weipu Journal Full-text Database(VIP) online, all from December 2018 since the building of the library about a randomized controlled trial of consciousness restoring for resuscitation acupuncture therapy in the treatment of dysphagia after stroke.Two researchers screened the literature and extracted the data according to the inclusion and exclusion criteria. The risk of bias of the included studies was assessed according to Cochrane handbook 5.1.0, and the methodological quality was assessed by Jadad scale.Morever,the Review manager 5.3 software was used for statistical analysis. Results A total of 22 literatures meeting the standards were included, and a total of 1998 cases were accumulated.The results of Meta-analysis showed that the total effective rate, cure rate, Kubota water swallowing tes(WST), Fjishima Tchiro rating scale(FTRS), standard swallowing function evaluation score(SSA) were significantly higher than those in the control group. Conclusion Consciousness restoring for resuscitation acupuncture therapy has a good effect on dysphagia after stroke. However, due to the limited number and low quality of the included literatures, more high-quality RCT tests are needed to verify the clinical effect of activiting brain and regaining consciousness acupuncture therapy on dysphagia after stroke.

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