针刺治疗脑卒中后吞咽障碍临床疗效的系统评价

目的 采用Meta分析评价针刺与其他常规方法治疗脑卒中后吞咽障碍的临床疗效。方法 计算机检索建库至2018年12月中国期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库、PubMed数据库中针刺治疗脑卒中后吞咽障碍的临床随机对照研究，并辅以人工检索湖南中医药大学图书馆的过刊资料库，制定文献纳入及排除标准，提取资料，评价纳入文献的质量，利用Revman 5.3软件进行Meta分析。结果 共纳入28篇文献，病例数2 557例。Meta分析结果提示治疗组对吞咽障碍的总有效率优于对照组（Z=12.51，P<0.000 01），且治疗组在改善MBI评分、SWAL-QOL评分方面优于对照组，差异有统计学意义（P<0.05）；但治疗组在改善患者肺部感染情况上无明显优势，与治疗组差异无统计学意义（P>0.05）。结论 针刺治疗脑卒中后吞咽障碍可提高现代康复治疗的临床疗效，有助于改善患者日常生活活动能力和生活质量，但由于本研究纳入的文献数量和质量存在不足，仍需进一步研究予以证实。

Systematic Evaluation of Clinical Efficacy of Acupuncture in the Treatment of Post-stroke Dysphagia

Objective To evaluate the clinical efficacy of acupuncture and other regular methods on post-stroke dysphagia by Meta-analysis. Methods The literature on clinical randomized control trials of acupuncture in the treatment of post-stroke dysphagia was searched from China National Knowledge Infrastructure (CNKI), Wan Fang database, VIP database, China Biology Medicine disc (CBMdisc), Pub Meddatabase by computer and a manual search of Hunan University of Traditional Chinese Medicine library journal database. The retrieval time was from the establishment to the December 2018. Literature inclusion andexclusion criteria wereestablished to extract data, and the quality of the included studies was assessed. A Meta-analysis was performed by using Revman 5.3 software. Results A total of 28 paperswere included, involving 2 557 patients. Meta-analysis results showed that the total effective rate of the treatment group for dysphagia was superior to the control group (Z=12.51, P<0.000 01), and the MBI score and SWAL-QOL score improvement of the treatment group were better than the control group, with statistically significant difference (P<0.05). But the treatment group had no significant advantages in the improvement of pulmonary infection, and there was no statistically significant difference when compared with the treatment group (P>0.05). Conclusion The application of acupuncture can improve the clinical effect of modern rehabilitation therapy on dysphagia after stroke and help to improve the patients'' ability of daily life activities and quality of life. However, due to the insufficient quantity and quality of literature included in this study, more studies are needed to confirm the conclusion.