Effect of Acupuncture on Dysphagia after Stroke: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

Cerebrovascular Diseases Pub Date : 2025-02-18 DOI:10.1159/000544743

Jiongliang Zhang, Minmin Wu, Xinyue Li, Donghui Yu, Huanhuan Jia, Binhan Wang, Yuting Wang, Yumeng Su, Xiangyu Wei, Luwen Zhu

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引用次数: 0

Abstract

Introduction: Poststroke dysphagia (PSD) is a highly prevalent dysfunction after stroke, characterized by high mortality and seriously affecting the quality of life of patients. Previous studies have shown that acupuncture improves symptoms of PSD. However, repeated tests of significance may exaggerate type I errors. The aim of the study was to update the evidence on the effectiveness and safety of acupuncture for PSD using a meta-analysis and trial sequential analysis (TSA).

Methods: A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify randomized controlled trials evaluating the effects of acupuncture on PSD. Trials published up to September 15, 2024, meeting the predetermined inclusion criteria, were included.

Results: Twenty studies involving 1,718 participants were included. Combined acupuncture with rehabilitation therapies significantly improved the Standard Swallowing Assessment (mean difference [MD] = -3.64, 95% confidence interval [CI]: -4.72 to -2.56, p < 0.0001), Video Fluoroscopic Swallowing Study scale (MD = 1.49, 95% CI: 0.89 to 2.09, p < 0.0001), Water Swallow Test (MD = -0.72, 95% CI: -0.96 to -0.47, p < 0.0001), and Swallowing Quality of Life Questionnaire (MD = 16.56, 95% CI: 9.94 to 23.18, p < 0.0001). TSA indicated that the sample size exceeded the required information size. In addition, acupuncture showed safety for PSD treatment (relative ratio = 1.23, 95% CI: 0.70 to 2.17, p = 0.48); however, the sample size was insufficient.

Conclusions: TSA demonstrated the positive effects of acupuncture on swallowing function in patients with PSD. Nonetheless, high-quality trials are needed to validate the safety of acupuncture.

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针刺对中风后吞咽困难的影响：随机对照试验的荟萃分析和试验序贯分析。

卒中后吞咽困难（PSD）是卒中后非常普遍的一种功能障碍，其特点是死亡率高，严重影响患者的生活质量。先前的研究表明，针灸可以改善PSD的症状。然而，重复的显著性检验可能会夸大I型错误。通过荟萃分析和试验序贯分析（TSA）更新针灸治疗PSD的有效性和安全性的证据。方法：综合检索PubMed、Embase、Cochrane Library和Web of Science，确定评估针灸治疗PSD效果的随机对照试验。纳入2024年9月15日前发表的符合预定纳入标准的试验。结果：纳入20项研究，共1718名受试者。针刺结合康复治疗显著改善了标准吞咽评估（mean difference [MD] = -3.64, 95%可信区间（CI）： -4.72 ~ -2.56, p < 0.0001）、影像透视吞咽研究量表（MD = 1.49, 95% CI: 0.89 ~ 2.09, p < 0.0001）、水吞试验（MD = -0.72, 95% CI: -0.96 ~ -0.47, p < 0.0001）和吞咽生活质量问卷（MD = 16.56, 95% CI: 9.94 ~ 23.18, p < 0.0001）。TSA指出样本数量超过了要求的信息量。此外，针刺治疗PSD具有安全性（相对比[RR] = 1.23, 95% CI: 0.70 ~ 2.17, p = 0.48）；然而，样本量不足。结论：TSA显示针刺对PSD患者吞咽功能有积极作用。然而，需要高质量的试验来验证针灸的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.