The Effect Of Acupuncture On The Treatment Of Dysphagia After Stroke

ObjectiveThrough retrieving published literature about acupuncture treatment of postst roke dysphagia randomized controlled trials, evaluating the efficacy and safety o f acupuncture for the treatment of poststroke dysphagia.MethodsAccording to the inclusion and exclusion criteria, retrieving the domestic an d overseas database.two reviewers were determined included literature, if encoun tered controversy, the two parties decided to participate in the discussion or a third decided.A systematic review included studies be evaluated with GRADE Level quality evaluation literature, and through the Cochrane Collaboration dedi cated statistical package (Review Manager 5.3.5), qualitative and meta-analysis.Results(1) A total of 14 literatures were included, the total sample size of 1155 ev ents,582 cases in the experimental group, the control group of 572 cases.Grou ped according to the intervention,12 articles of acupuncture combined with the foundation treatment compared with foundation.1 articles of acupuncture combin ed with the foundation treatment compared with Vocastim-Master with foundati on,l articles of acupuncture compared with comprehensive rehabilitation training.(2)The main outcome measured with the total efficiency,acupuncture combin ed with foundation treatment and foundation (RR=1.16,95%CI[1.06,1.28]),acupun cture combined with the foundation treatment compared and Vocastim-Master w ith foundation(RR=1.03,95%CI[0.92,1.15]),acupuncture and comprehensive rehabi litation training (RR=1.25,95%CI[0.93,1.69]).(3)Secondary outcomes:(sub-water test score:acupuncture combined with the f oundation treatment and foundation (MD=-0.65,95% CI[-0.88,-0.43]);(dysphagia e valuation rating score:acupuncture combined with the foundation treatment and foundation (MD=1.60,95%CI[1.21,1.99]);(deglutition disorder score:acupuncture c ombined with the foundation treatment and foundation treatment control group (MD=1.09,95%CI[0.63,1.55]);④the rate of pulling out the nasal feeding tube:acu puncture combined with the foundation treatment and foundation treatment cont rol group (RR=1.79,95%CI[1.27,2.53]);⑤nutrition indices:acupuncture compared with comprehensive rehabilitation training MNA(MD=-0.30,95%CI[-1.45,0.85]),B I(MD=4.83,95%CI[-1.57,11.23]),MAMC(MD=0.04,95%CI[-0.04,0.12]), TSF(MD= 0.02,95%CI[-0.04,0.08]);⑥VFSS:acupuncture combined with the foundation treat ment and Vocastim-Master with foundation (MD=0.42,95%CI[-0.04,0.88])Conclusions(1) Based on fundamental treatment,acupuncture can collectively improve t he clinical efficiency and clinical cure rate. The quality of evidences is moder ate grade.(2)Based on fundamental treatment,acupuncture can collectively improve th e rate of pulling out the nasal feeding.The quality of evidences is low grade.(3)Based on fundamental treatment,acupuncture can improve the clinical eff iciency and deglutition disorder score more than Vocastim-Master.The quality of evidences is low grade.Beacuse the sample is small, pending further study to im-prove.(4)acupuncture can improve the clinical efficiency and nutrition indices mor e than comprehensive rehabilitation training.But the sample is small,the quality o f evidences is low grade.(5)The long-term evaluation of acupuncture treatment of poststroke dyspha gia cannot be improved,need more clinical literature reports.