Systematic Evaluation Of Clinical Efficacy Of Acupuncture Combined Rehabilitation Training In Treating Dysphagia After Stroke

Objective: To systematically evaluate the clinical effect of acupuncture and moxibustion combined rehabilitation training on dysphagia after stroke.Methods: The article strictly follows the requirements of Cochrane Review Handbook 5.1 To systematically evaluate randomized controlled trial study was conducted.Steps as follows: 1.Determine the topic,make a protocol,including the background,purpose,content retrieval method and strategy of the literature,select the qualified standard of literature,to evaluate the quality of the literature method,the method of data collection and analysis,etc.2.Explore Literature.3.Select and analyze the literature.4.Assessment of the risk of bias included in the study.5.collect data.6.Data analysis and results report.7.Explain the results of system evaluation.Results: A total of 2610 patients with dysphagia after a stroke were screened by rigorous screening of 18 randomized controlled trials.Quality evaluation is high bias.System evaluation results show: a total of 18 randomized controlled trials were included in the total clinical efficacy assessment,with a total sample size of 1451,heterogeneity test?~2=13.20,df=17,P=0.72,I~2=0%,the homogeneity of the data can be combined with the fixed effect model calculated statistic OR=4.05,95%CI(3.03,5.42),combined effect measurement=9.40,P<0.05.A total of 5 studies were included in the evaluation of drinking water test in the depression.The total sample size was 392,heterogeneity test:?~2=6.63,df=4,P=0.16,I~2=40%,the homogeneity of the data can be combined with the fixed effect model,calculated statistic MD=-0.61,95%CI ?(-0.80,-0.43),Z=6.52,P<0.05 },combined effect measurement Z=9.40,P<0.05.In the evaluation of swallowing disorder scale,5 studies were included,with a total sample size of 467,heterogeneity test:?~2=52.45,df=4,P<0.00001,I~2=92%,the heterogeneity of the data can be combined with the random effect model,calculated statistic MD=1.40,95%CI(0.56,0.25),combined effect measurement Z=3.42,P<0.05.Five original studies were included in the evaluation of the swallowing function television fluoroscopy(VFSS),and the data were heterogeneous,?~2 =21.43,df=3,P<0.00001,I~2=86%,the heterogeneity of the data can be combined with the random effect model,calculated statistic MD=1.24,95%CI(0.28,2.11),combined effect measurement Z=2.58,P<0.05.Conclusion: Compared with the control group,the total clinical efficiency of the experimental group was significantly improved{OR=4.05,95%CI(3.03,5.42),Z=9.40,P<0.05};Water test scores in the experimental group were significantly reduced{MD=-0.61,95%CI(-0.80,-0.43),Z=6.52,P<0.05 };The score of swallowing disorder was significantly increased in the experimental group,{MD=1.40,95%CI(0.56,0.25),Z=3.42,P<0.05};There was a significant increase in the scores of the experimental group swallowing function TV fluoroscopy{MD=1.24,95%CI(0.28,2.11),combined effect measurement Z=2.58,P<0.05}.The grading system recommended by GRADE system is used to evaluate the quality of evidence,The quality level of the evidence is low and the recommended strength is weak recommendation.Above all,acupuncture and moxibustion in combination with rehabilitation training can obviously improve the clinical curative effect,however,the low quality of original literature limits the credibility of the conclusion,the need to constantly explore the clinical treatment,and pay attention to high quality,large sample,multicenter,randomized,controlled study,so as to obtain high-level evidence-based medical evidence,in order to better guide the clinical treatment of swallowing disorders after stroke.