灸法治疗脑卒中后吞咽障碍疗效和安全性Meta分析

Meta-analysis on the Efficacy and Safety of Moxibustion for Post-stroke Dysphagia

目的以Meta分析方法评价灸法治疗脑卒中后吞咽障碍患者的疗效和安全性。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、Web of Science、the Cochrane Library、PubMed、EMbase建库至2023年6月30日灸法治疗脑卒中后患者吞咽障碍随机对照试验。使用R语言4.3.0版本meta、metafor程序包分析数据并将结果可视化。结果共纳入研究20项,涉及患者1579例。结果显示,试验组临床总有效率高于对照组[RR=1.20,95%CI(1.14,1.25),P<0.0001];试验组在降低洼田饮水试验评分[MD=-0.90,95%CI(-1.05,-0.76),P<0.0001]、提高VFSS评分[MD=1.81,95%CI(0.83,2.80),P=0.0003]、降低SSA评分[MD=-4.26,95%CI(-5.14,-3.38),P<0.0001]、提高咽侧壁活动度[MD=0.06,95%CI(0.02,0.10),P=0.0028]、降低并发症发生率[RR=0.45,95%CI(0.32,0.62),P<0.0001]方面均优于对照组。结论灸法治疗脑卒中后吞咽障碍患者疗效显著,且能显著降低并发症发生率,但受纳入研究的质量限制,未来仍需更多高质量、设计严谨的研究加以验证。

Objective To evaluate the efficacy and safety of moxibustion in the treatment of patients with post-stroke dysphagia using Meta-analysis.Methods Random controlled trials(RCTs)about moxibustion in the treatment of patients with post-stroke dysphagia were retrieved from CNKI,Wanfang Data,VIP,CBM,Web of Science,the Cochrane Library,PubMed,and EMbase from the establishment of the databases to June 30,2023.Data were analyzed and the results were visualized using R language version 4.3.0 packages such as meta and metafor.Results Totally 20 RCTs were included,involving 1579 patients.The results showed that the total clinical effective rate of the experimental group was higher than that of the control group[RR=1.20,95%CI(1.14,1.25),P<0.0001];the experimental group was superior to the control group in reducing the Wada drinking water test score[MD=-0.90,95%CI(-1.05,-0.76),P<0.0001],increasing the VFSS score[MD=1.81,95%CI(0.83,2.80),P=0.0003],reducing the SSA score[MD=-4.26,95%CI(-5.14,-3.38),P<0.0001],increasing pharyngeal lateral wall mobility[MD=0.06,95%CI(0.02,0.10),P=0.0028],and reducing the incidence of complications[RR=0.45,95%CI(0.32,0.62),P<0.0001].Conclusion Moxibustion is remarkably effective in treating individuals with post-stroke dysphagia and can dramatically lower the risk of sequelae.However,due to the quality limitations of the included studies,more high-quality and well-designed studies are still needed in the future to support this conclusion.