醒脑开窍针治疗脑卒中患者吞咽困难疗效与安全性评价的Meta分析

Meta-analysis of Efficacy and Safety Evaluation of Xingnao Kaiqiao Needle in the Treatment of Dysphagia in Stroke Patients

目的:评价醒脑开窍针治疗脑卒中患者吞咽困难的疗效和安全性。方法:由2名研究者对中国知网(CNKI)、万方数据库以及中国维普全文数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、CochraneLibrary、Embase、Web of Science进行文献检索,检索时间为建库至2023年5月1日。采用Cochrane 5.1.0版偏倚风险工具对纳入文献进行文献质量的评估。通过对文献进行筛选、提取基本信息及对纳入文献的质量进行评价后,使用RevMan 5.4.1软件进行Meta分析。结果:共纳入28项随机对照试验(RCT)研究,共2879例患者。Meta分析结果显示,醒脑开窍针治疗可提高卒中患者吞咽障碍的临床疗效,有效率[OR=4.45,95%CI(3.40,5.83),P<0.00001],标准吞咽功能评价量表(SSA)[SMD=-1.14,95%CI(-1.42,-0.87),P<0.00001],洼田饮水试验(WST)[SMD=-2.73,95%CI(-3.53,-1.92),P<0.00001],视频吞咽造影检查(VFSS)评分[SMD=4.89,95%CI(2.80,6.97),P<0.00001],吞咽障碍特异性生活质量量表(SWAL—QOL)[SMD=1.30,95%CI(0.87,1.72),P<0.00001]。结论:醒脑开窍针刺治疗可提高脑卒中患者吞咽功能,提高患者的生活质量,改善预后,并且具备一定的安全性。

Objective To evaluate the efficacy and safety of Xingnao kaiqiao needle in the treatment of dysphagia in stroke patients.Methods A literature search was conducted on CNKI,Wanfang Database,VIP,CBM,PubMed,CochraneLibrary,Embase and Web of Science by two researchers.The retrieval time is from May 1,2023.The Cochrane 5.1.0 bias risk tool was used to assess the quality of the included literature.After literature screening,basic information extraction and quality evaluation of the included literatures,Meta-analysis was performed using RevMan 5.4.1 software.Results A total of 28 randomized controlled trials(RCTS)were included,involving 2879 patients.The results of Meta-analysis showed that Xingnao kaiqiao acupuncture could improve the clinical efficacy and effective rate of dysphagia in stroke patients[OR=4.45,95%CI(3.40,5.83),P<0.00001],the standard swallowing function assessment scale(SSA)[SMD=-1.14,95%CI(-1.42,-0.87),P<0.00001],kubota drinking water test(WST)[SMD=-2.73,95%CI(-3.53,-1.92),P<0.00001],VFSS score[SMD=4.89,95%CI(2.80,6.97),P<0.00001],SWAL-QOL[SMD=1.30,95%CI(0.87,1.72),P<0.00001].Conclusion Xingnao kaiqiao acupuncture treatment can improve the swallowing function,improve the quality of life,improve the prognosis of patients with stroke,and has certain safety.