Systematic evaluation and meta-analysis of the effect of acupuncture combined with rehabilitation training on dysphagia after stroke_West China Medical Journal

Authors：

TANG Qiang ¹ , ZHAO Xiaoqian ² ,  ZHU Luwen ¹

1. The Rehabilitation Center, the Second Hospital Affiliated to Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150001, P. R. China;
2. The Second Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;

Corresponding?author：

ZHU Luwen, Email: zhuluwen1983@126.com

Keywords：

Acupuncture; Rehabilitation training; Stroke; Dysphagia; Systematic review; Meta-analysis

DOI：

10.7507/1002-0179.201903221

Video：

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Objective To systematically evaluate the effectiveness of acupuncture combined with rehabilitation training compared with simple rehabilitation training or acupuncture treatment of dysphagia after stroke, and make clear whether the effect of acupuncture combined with rehabilitation training is better than simple rehabilitation training or acupuncture treatment.Methods Six databases including China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP, PubMed, Cochrance Library, and Embase were searched by computer for the randomized controlled trials on acupuncture combined with rehabilitation training treatment of post-stroke dysphagia, which were published from January 1st, 2010 to December 31st, 2018. After literature including, excluding, and screening, RevMan 5.3 software was used to conduct a meta-analysis.Results A total of 22 studies were included, including 1 987 patients. All the included studies took simple rehabilitation training or rehabilitation training combined with sham acupuncture as the control. Meta-analysis of efficiency and outcome measures for relevant studies showed that: compared with simple rehabilitation training, the effectiveness of acupuncture combined with rehabilitation training on post-stroke dysphagia was higher [17 studies included; odds ratio=3.66, 95% confidence interval (CI) (2.66, 5.05), P<0.000 01], the video fluoroscopy swallowing study score of acupuncture combined with rehabilitation training after treatment was higher [8 studies included; mean difference (MD)=2.31, 95%CI (1.75, 2.87), P<0.000 01], and the StandardizedSwallowing Assessment score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=?3.20, 95%CI (?3.78, ?2.61), P<0.000 01]; at the same time the Watian Drinking Water Test score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=?0.65, 95%CI (?0.91, ?0.39), P<0.000 01].Conclusions Acupuncture combined with rehabilitation training is effective in dysphagia after stroke, and the combined effect is better than simple rehabilitation training. However, due to the limitations of quality of included literature and sample size, the above results and conclusions still require high quality and large sample studies to testify.

Citation： TANG Qiang, ZHAO Xiaoqian, ZHU Luwen. Systematic evaluation and meta-analysis of the effect of acupuncture combined with rehabilitation training on dysphagia after stroke. West China Medical Journal, 2019, 34(5): 531-538. doi: 10.7507/1002-0179.201903221 Copy

1.	黃健婷, 羅曉舟, 崔韶陽, 等. 針刺結合康復訓練對缺血性腦卒中患者吞咽障礙臨床療效觀察及對血清 BDNF 的影響. 中華中醫藥雜志, 2019, 34(2): 830-833.
2.	湯小榮, 王琳, 黃培冬, 等. 針刺聯合康復療法治療中風后吞咽障礙的 Meta 分析. 廣州中醫藥大學學報, 2019, 36(4): 514-520.
3.	馮聲旺, 曹淑華, 杜淑佳, 等. 針刺配合吞咽訓練治療腦卒中后吞咽障礙: 隨機對照研究. 中國針灸, 2016, 36(4): 347-350.
4.	包芳, 陳可. 針刺結合吞咽功能訓練對腦卒中后吞咽功能障礙的干預作用研究. 湖北中醫藥大學學報, 2018, 20(6): 87-90.
5.	夏雋暉, 許翠娥, 夏文廣, 等. 針刺聯合康復訓練對腦卒中后吞咽障礙的影響. 湖北中醫藥大學學報, 2015, 17(4): 88-90.
6.	張達彬, 梁志安, 鐘燕文. Vitalstim 電針結合吞咽訓練治療腦卒中后吞咽障礙的療效. 心血管康復醫學雜志, 2016, 25(3): 335-338.
7.	李振華. 針刺人迎、水突為主穴配合功能恢復訓練治療中風后吞咽困難. 中西醫結合心腦血管病雜志, 2015, 13(17): 1934-1936.
8.	楊海芳, 李小霞, 王婷. 電針聯合康復訓練治療腦卒中后吞咽障礙的電視熒光透視研究. 廣州中醫藥大學學報, 2011, 28(3): 239-242.
9.	王彥華, 楊國防, 周紅霞, 等. 針刺配合康復訓練治療中風后吞咽障礙臨床觀察. 上海針灸雜志, 2017, 36(6): 663-667.
10.	陳丹, 郭海英. 針刺結合康復訓練治療卒中后假性延髓麻痹吞咽障礙療效觀察. 中國針灸, 2018, 38(4): 364-368.
11.	劉艷貞. 針灸結合康復功能訓練治療腦卒中后吞咽障礙療效分析. 實用醫院臨床雜志, 2018, 15(2): 163-166.
12.	尹麗麗. 針刺配合康復療法治療中風后吞咽障礙 57 例臨床研究. 中醫雜志, 2013, 54(9): 766-768.
13.	韓林, 高旸. 針刺配合康復訓練治療卒中后吞咽障礙療效觀察. 上海針灸雜志, 2017, 36(8): 910-913.
14.	張帥, 張根明. 針刺聯合吞咽康復訓練治療卒中后吞咽障礙 87 例. 安徽中醫藥大學學報, 2014, 33(5): 56-59.
15.	楊春光, 朱彬, 廖明霞, 等. 電針頭針配合吞咽訓練治療腦卒中后假性球麻痹吞咽障礙臨床研究. 四川中醫, 2016, 34(6): 195-198.
16.	王俊卿, 孫玉嬌, 朱銀星, 等. 電針配合康復訓練對腦卒中后吞咽障礙療效觀察. 中國中醫急癥, 2012, 21(10): 1701-1702.
17.	陳璐, 張根明. 針灸綜合康復方案治療中風后吞咽障礙療效觀察. 中國中醫急癥, 2016, 25(6): 1111-1113.
18.	高升, 黃煥珍, 李素芬. 吞咽功能訓練聯合針刺治療腦卒中后吞咽障礙療效觀察. 海南醫學, 2016, 27(15): 2531-2533.
19.	李智, 焦富英. 針刺聯合吞咽功能訓練治療腦卒中后吞咽功能障礙的臨床研究. 針灸臨床雜志, 2018, 34(10): 10-13.
20.	武平, 梁繁榮, 于白莉, 等. 不同時期介入針刺和康復訓練對腦卒中后吞咽障礙療效的影響. 中國康復理論與實踐, 2011, 17(8): 733-736.
21.	張生玉, 劉哨兵, 吳偉, 等. Vitalstim 穴位電針法聯合康復訓練治療腦卒中后吞咽障礙的療效觀察. 針刺研究, 2017, 42(2): 168-172.
22.	朱金妹, 何俊, 焦素芹, 等. 針刺聯合康復治療對腦卒中后阻塞性睡眠呼吸暫停并吞咽障礙臨床觀察. 上海針灸雜志, 2018, 37(12): 1368-1372.
23.	李寶棟, 白晶, 劉濤, 等. " 皮層-咽部-舌根”序貫針刺法聯合吞咽訓練治療腦卒中后吞咽障礙療效觀察. 現代中西醫結合雜志, 2015, 24(32): 3599-3601.
24.	Xia W, Zheng C, Zhu S, et al. Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? A randomized controlled trial. Clin Rehabil, 2016, 30(3): 237-246.
25.	石琳. 針刺聯合康復訓練治療卒中后吞咽功能障礙的循證醫學研究. 針灸臨床雜志, 2018, 34(7): 62-66.

1. 黃健婷, 羅曉舟, 崔韶陽, 等. 針刺結合康復訓練對缺血性腦卒中患者吞咽障礙臨床療效觀察及對血清 BDNF 的影響. 中華中醫藥雜志, 2019, 34(2): 830-833.
2. 湯小榮, 王琳, 黃培冬, 等. 針刺聯合康復療法治療中風后吞咽障礙的 Meta 分析. 廣州中醫藥大學學報, 2019, 36(4): 514-520.
3. 馮聲旺, 曹淑華, 杜淑佳, 等. 針刺配合吞咽訓練治療腦卒中后吞咽障礙: 隨機對照研究. 中國針灸, 2016, 36(4): 347-350.
4. 包芳, 陳可. 針刺結合吞咽功能訓練對腦卒中后吞咽功能障礙的干預作用研究. 湖北中醫藥大學學報, 2018, 20(6): 87-90.
5. 夏雋暉, 許翠娥, 夏文廣, 等. 針刺聯合康復訓練對腦卒中后吞咽障礙的影響. 湖北中醫藥大學學報, 2015, 17(4): 88-90.
6. 張達彬, 梁志安, 鐘燕文. Vitalstim 電針結合吞咽訓練治療腦卒中后吞咽障礙的療效. 心血管康復醫學雜志, 2016, 25(3): 335-338.
7. 李振華. 針刺人迎、水突為主穴配合功能恢復訓練治療中風后吞咽困難. 中西醫結合心腦血管病雜志, 2015, 13(17): 1934-1936.
8. 楊海芳, 李小霞, 王婷. 電針聯合康復訓練治療腦卒中后吞咽障礙的電視熒光透視研究. 廣州中醫藥大學學報, 2011, 28(3): 239-242.
9. 王彥華, 楊國防, 周紅霞, 等. 針刺配合康復訓練治療中風后吞咽障礙臨床觀察. 上海針灸雜志, 2017, 36(6): 663-667.
10. 陳丹, 郭海英. 針刺結合康復訓練治療卒中后假性延髓麻痹吞咽障礙療效觀察. 中國針灸, 2018, 38(4): 364-368.
11. 劉艷貞. 針灸結合康復功能訓練治療腦卒中后吞咽障礙療效分析. 實用醫院臨床雜志, 2018, 15(2): 163-166.
12. 尹麗麗. 針刺配合康復療法治療中風后吞咽障礙 57 例臨床研究. 中醫雜志, 2013, 54(9): 766-768.
13. 韓林, 高旸. 針刺配合康復訓練治療卒中后吞咽障礙療效觀察. 上海針灸雜志, 2017, 36(8): 910-913.
14. 張帥, 張根明. 針刺聯合吞咽康復訓練治療卒中后吞咽障礙 87 例. 安徽中醫藥大學學報, 2014, 33(5): 56-59.
15. 楊春光, 朱彬, 廖明霞, 等. 電針頭針配合吞咽訓練治療腦卒中后假性球麻痹吞咽障礙臨床研究. 四川中醫, 2016, 34(6): 195-198.
16. 王俊卿, 孫玉嬌, 朱銀星, 等. 電針配合康復訓練對腦卒中后吞咽障礙療效觀察. 中國中醫急癥, 2012, 21(10): 1701-1702.
17. 陳璐, 張根明. 針灸綜合康復方案治療中風后吞咽障礙療效觀察. 中國中醫急癥, 2016, 25(6): 1111-1113.
18. 高升, 黃煥珍, 李素芬. 吞咽功能訓練聯合針刺治療腦卒中后吞咽障礙療效觀察. 海南醫學, 2016, 27(15): 2531-2533.
19. 李智, 焦富英. 針刺聯合吞咽功能訓練治療腦卒中后吞咽功能障礙的臨床研究. 針灸臨床雜志, 2018, 34(10): 10-13.
20. 武平, 梁繁榮, 于白莉, 等. 不同時期介入針刺和康復訓練對腦卒中后吞咽障礙療效的影響. 中國康復理論與實踐, 2011, 17(8): 733-736.
21. 張生玉, 劉哨兵, 吳偉, 等. Vitalstim 穴位電針法聯合康復訓練治療腦卒中后吞咽障礙的療效觀察. 針刺研究, 2017, 42(2): 168-172.
22. 朱金妹, 何俊, 焦素芹, 等. 針刺聯合康復治療對腦卒中后阻塞性睡眠呼吸暫停并吞咽障礙臨床觀察. 上海針灸雜志, 2018, 37(12): 1368-1372.
23. 李寶棟, 白晶, 劉濤, 等. " 皮層-咽部-舌根”序貫針刺法聯合吞咽訓練治療腦卒中后吞咽障礙療效觀察. 現代中西醫結合雜志, 2015, 24(32): 3599-3601.
24. Xia W, Zheng C, Zhu S, et al. Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? A randomized controlled trial. Clin Rehabil, 2016, 30(3): 237-246.
25. 石琳. 針刺聯合康復訓練治療卒中后吞咽功能障礙的循證醫學研究. 針灸臨床雜志, 2018, 34(7): 62-66.

West China Medical Journal

Systematic evaluation and meta-analysis of the effect of acupuncture combined with rehabilitation training on dysphagia after stroke

Abstract Full text Figures/Tables Video References Cited by

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