针刺结合言语康复训练治疗脑卒中后构音障碍有效性和安全性的Meta分析
Meta-analysis of the effectiveness of acupuncture combined with speech rehabilitation training in treating dysar-thria following stroke
彭涵钰 1王爱成1
作者信息
- 1. 100029 北京市,北京中医药大学;北京中医药大学第三附属医院
- 折叠
摘要
目的 旨在通过系统性地评估针刺疗法在治疗脑卒中后构音障碍时所取得的有效性和安全性,以便为其在实践中的运用提供参考.方法 本文检索9个中英文数据库中关于针刺结合言语康复训练治疗脑卒中后构音障碍的临床随机对照研究文献,检索时限均为2017年1月-2023年1月.中文数据库包括中国期刊全文数据库(CNKI)、万方数据资源系统(WF)、维普数据库(VIP)和中国生物医学文献数据库(CBM).英文数据库包括 PubMed、Web of science、Embase、Medline 和 Cochrane Library.通过 Rev-Man 5.4 软件对纳入的研究进行Meta分析.结果 本研究确定了满足条件的18篇文献,涉及患者数1 525例.所选的评估指标包括临床有效率、改良Frenchay构音障碍评价量表(FDET)积分、改良FDET评级(a项数).其中16篇文献采用了临床有效率进行评估,Meta分析结果显示OR=4.49,95％CI:3.21～6.29,P＜0.00001.3篇文献采用了改良FDET评分量表1(分数越高提示构音功能越好),Meta分析结果显示OR=6.66,95％CI:3.65～9.68,P＜0.0001.2篇文献采用改良FDET评分量表2(分数越低提示构音功能越好),Meta分析结果显示 OR=-9.30,95％CI:-12.58～-6.03,P＜0.00001.5 篇文献采用改良 FDET 评级(a 项数),Me-ta分析结果显示OR=5.08,95％CI:3.11～7.04,P＜0.00001.在针刺干预手段方面,腧穴选择频率较高的是舌三针、1个穴对(金津、玉液)、廉泉、风池、百会,并且金津、玉液常被使用于点刺放血.所有研究均未发生严重的不良反应事件.结论 通过采用针刺结合言语康复训练治疗,可显著改善脑卒中患者的言语能力,同时保障治疗的安全性.
Abstract
Objective This study aimed to systematically evaluate the effectiveness and safety of acupuncture therapy in treating dysarthria following stroke,providing reference for its practical application.Methods We searched nine Chinese and English databases for clinical randomized controlled trials on acupuncture combined with speech rehabilitation training for post-stroke dysarthria from January 2017 to January 2023.Chinese da-tabases included China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and Chi-nese Biomedical Literature Database(CBM).English databases included PubMed,Web of Science,Embase,Medline,and Cochrane Library.Meta-analysis was conducted using Rev-Man 5.4 software for the included studies.Results This study identified 18 eligible articles involving a total of 1,525 patients.The selected as-sessment indicators included clinical effective rate,modified Frenchay Dysarthria Assessment(FDET)score,and modified FDET rating(number of items rated in category a).Among them,16 articles utilized clinical efficacy rate for evaluation.Meta-analysis results revealed OR=4.49,95％CI:3.21～6.29,P＜0.00001.Three articles employed modified FDET score 1(higher scores indicating better articulatory function),with a meta-analysis result showing OR=6.66,95％CI:3.65～9.68,P＜0.0001.Two articles used modified FDET score two(lower scores indicating better articulation function),with meta-analysis showing OR=9.30,95％CI:-12.58～-6.03,P＜0.00001.Five articles used modified FDET rating('a'items),with meta-analysis showing OR=5.08,95％CI:3.11～7.04,P＜0.00001.Regarding acupuncture intervention,com-monly used acupoints included Tongue Three Needles,one pair of points(Jinjin and Yuye),Lianquan,Feng-chi,and Baihui,with Jinjin and Yuye often used for bloodletting.No serious adverse events were reported in any of the studies.Conclusion Acupuncture combined with speech rehabilitation training significantly im-proves the speech ability of stroke patients while ensuring treatment safety.
关键词
脑卒中/构音障碍/针刺治疗/言语康复训练/Meta分析Key words
Stroke/Articulation disorders/Acupuncture/Speech rehabilitation training/Meta-analy-sis引用本文复制引用
基金项目
北京中医药大学临床学习一流学科建设项目(90010961020088)
出版年
2024
NETL
NSTL
万方数据