针药结合治疗中风后假性球麻痹吞咽障碍Meta分析

Meta-analysis of Acupuncture Combined with TCM in the Treatment of Dysphagia Caused by Pseudobulbar Paralysis after Apoplexy

目的循证评价中医针药结合在治疗中风后假性球麻痹吞咽障碍时的干预效果,为本病临床诊疗提供一定的循证依据和治疗思路。方法运用计算机检索常用文献数据库,检索时间为建库至2019年2月,根据纳入排除标准,纳入所有针药结合治疗本病的RCT和半随机对照试验(q RCT),所有纳入患者均被明确诊断为本病。采用Revman 5.3软件进行Meta分析。结果最终纳入研究32篇。Meta分析表明,针药结合与针刺、中药、西药、空白对照总有效率相比分别为RR=1.23,95%CI[1.17,1.30],RR=1.36,95%CI[1.21,1.52],RR=1.16,95%CI[1.06,1.27],RR=1.20,95%CI[1.16,1.24],P <0.01。结论针药结合对本病恢复有利,不良反应尚不明确,但因缺乏高质量的相关文献,证据仍不充分,尚需大量高质量大样本RCT对疗效进行证实。

Objective Evidence-based evaluation of the intervention effect of TCM combined with acupuncture in the treatment of dysphagia after stroke, the aim is to provide some evidence-based basis and treatment ideas for clinical diagnosis and treatment. Methods We use PC to search the common literature databases from building the library to Feb 2019. All RCT and qRCT of acupuncture combined with TCM were included to treat the disease. All included patients were clearly diagnosed. Meta-analysis was carried out by Revman5.3 software. Results 32 articles were included in the study. Meta-analysis showed that the total effective rates of acupuncture and TCM combined with acupuncture, TCM, western medicine and control group were RR=1.23, 95%CI[1.17,1.30], RR=1.36, 95%CI[1.21,1.52], RR=1.16, 95%CI[1.06,1.27], RR=1.20, 95%CI[1.16,1.24], P <0.01. Conclusion The way is beneficial to the recovery of the disease, and the adverse reactions are not clear. But due to the lack of high-quality relevant study, the evidence is still insufficient, and a large number of high-quality large samples of RCT are still needed to confirm the curative effect.