项针治疗中风后吞咽障碍疗效的国内文献Meta分析

A Meta-analysis of the Therapeutic Effect of Nape Acupuncture on Post-stroke dysphagia in Domestic Literature

目的利用Meta分析评价项针治疗中风后吞咽障碍的临床疗效。方法计算机检索中国知网(CNKI)、万方数据医药信息系统(WF)、维普信息资源系统(VIP)、中国生物医学文献数据库(CBM)并辅以手工检索暨南大学图书馆过刊资料库,收集2004年6月至2014年6月间关于项针治疗中风后吞咽障碍的国内临床随机对照研究。制定文献纳入及排除标准,提取资料并利用Jadad评分量表对纳入的研究进行质量评价。采用Review manager5.2软件进行Meta分析。结果共纳入文献17篇,累计患者1158例。Meta分析结果显示,项针治疗组与对照组相比,总有效率[OR=3.99,95%CI(2.83,5.63),P<0.00001]、治愈率[OR=2.67,95%CI(2.03,3.53),P<0.00001],差异均有统计学意义。结论项针治疗中风后吞咽障碍具有良好的临床疗效。但由于受制于纳入文献质量偏低等因素影响,仍需多中心、大样本、高质量的研究加以验证。

Objective To investigate the clinical effect of nape acupuncture on post-stroke dysphagia by a meta-analysis. Method Domestic literature on clinical randomized controlled trials of nape acupuncture treatment of post-stroke dysphagia published from Jun. 2004 to Jun. 2014 were obtained by a computer search of China National Knowledge Internet（CNKI）, Wanfang Data medical information system（WF）, VIP information resource system（VIP） and Chinese Biomedical Literature Database（CBM） combined with a manual search of Jinan University library journal database. Literature inclusion and exclusion criteria were established to extract data and the qualities of the included studies were assessed using a Jadad rating scale. A meta-analysis was made using the software Review Manager 5.2. Result A total of 17 articles were included with 1158 patients. The results of meta-analysis showed that there were statistically significant differences in the total efficacy rate [OR=3.99, 95% CI（2.83, 5.63）, P〈0.00001] and the cure rate [OR=2.67, 95% CI（2.03, 3.53）, P〈0.00001] between the nape acupuncture and control groups. Conclusion Nape acupuncture has clinically a good therapeutic effect on post-stroke dysphagia. Multi-center, large-sample and high-quality studies are still needed for validation because the qualities of the included articles are lower, which is one of the factors influencing the assessment.