| 刘晟,裴子文,孟宪梅.神经肌肉电刺激治疗脑卒中后吞咽障碍的系统评价及Meta分析[J].中国康复,2019,34(8):426-431 |
| 神经肌肉电刺激治疗脑卒中后吞咽障碍的系统评价及Meta分析 |
| Effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: A systemic review and meta-analysis |
| |
| DOI： |
| 中文关键词: 神经肌肉电刺激 脑卒中 吞咽障碍 |
| 英文关键词: Neuromuscular electrical stimulation stroke dysphagia |
| 基金项目:武汉大学医学部科研项目资助（2017052） |
|
| 摘要点击次数: 7493 |
| 全文下载次数: 4443 |
| 中文摘要: |
| 目的：综合评价神经肌肉电刺激对脑卒中后吞咽障碍的治疗效果。方法：计算机检索The Cochrane Library、PubMed、Medline、WOS核心集合、CINAHL、EMbase、OCLC、ProQuest、中国知网（CNKI）、万方数据库、维普数据库、中国生物医学期刊数据库中关于神经肌肉电刺激治疗脑卒中后吞咽障碍的随机对照试验。采用5.1.0版Cochrane 评价手册对文献质量进行评价，RevMan 5.3软件对资料进行系统分析。结果：共纳入46篇随机对照试验（RCT）文献。30篇文献以吞咽功能评分为结局指标，评价了神经肌肉电刺激+常规吞咽训练与常规吞咽训练的治疗效果比较，Meta分析结果显示，SMD=0.60，95%CI=0.11~1.09（P＜0.05）；7篇文献以治疗效果是否有效为结局指标，评价了神经肌肉电刺激+常规吞咽训练与常规吞咽训练的治疗效果比较，Meta分析结果显示，OR=0.21，95%CI=0.13~0.35（P＜0.05）；4篇神经肌肉电刺激与常规吞咽训练比较，以吞咽功能评分为结局指标，Meta分析结果显示，SMD=0.04，95%CI=-0.19~0.26（P＞0.05）；3篇神经肌肉电刺激与针灸治疗效果比较，以吞咽功能评分为结局指标，Meta分析结果显示，SMD=0.52，95%CI=-0.21~1.26（P＞0.05）；3篇神经肌肉电刺激与电针治疗效果比较，以吞咽功能评分为结局指标，Meta分析结果显示，SMD=0.45，95%CI=-0.31~1.22（P＞0.05）；2篇神经肌肉电刺激与肌电反馈治疗效果比较，以吞咽功能评分为结局指标，Meta分析结果显示，SMD=0.77，95%CI=-0.05~1.58（P＞0.05）。结论：常规吞咽训练联合神经肌肉电刺激与单纯常规吞咽训练治疗效果比较有统计学提高；神经肌肉电刺激疗法与常规吞咽训练、针灸疗法治疗、电针疗法治疗、肌电生物反馈等相比治疗效果，无统计学差异。 |
| 英文摘要: |
| Objective: To comprehensively evaluate the therapeutic effect of neuromuscular electrical stimulation on dysphagia after stroke. Methods： This study searched the Cochrane Library, PubMed, Medline, WOS core collection, CINAHL, EMbase, OCLC, ProQuest, CNKI, Wanfang, VIP, and CBM about randomized controlled trials (RCT) of the treatment of neuromuscular stimulation on dysphagia after stroke. Cochrane Handbook version 5.1.0 was used to assess trial quality and RevMan 5.3 was used to analyze meta data. Results： A total of 46 RCT were included in this study. There were 30 articles about neuromuscular electrical stimulation with swallowing training vs. swallowing training only, and swallowing function score was used as the outcome measure. The meta analysis showed that SMD=0.60, 95%CI=0.11-1.09 (P< 0.05). There were 7 articles about neuromuscular electrical stimulation with swallowing training vs. swallowing training only, and effective rate was used as the outcome measure. The meta analysis showed that OR=0.21, 95%CI=0.13-0.35 (P<0.05). There were 4 articles on neuromuscular electrical stimulation vs. swallowing training, and the swallowing function score was used as the outcome measure. The meta analysis showed that SMD=0.04, 95%CI=-0.19-0.26 (P>0.05). There were 3 articles on the neuromuscular electrical stimulation vs. acupuncture, and swallowing function score was used as the outcome measures. The meta analysis showed that SMD=0.52, 95%CI=-0.21-1.26 (P>0.05). There were 3 articles on neuromuscular electrical stimulation vs. electroacupuncture, and the swallowing function score was used as the outcome measures. The meta analysis showed that SMD=0.45, 95%CI=-0.31-1.22 (P>0.05). There were 2 articles about neuromuscular electrical stimulation vs. myoelectric feedback, and swallowing function score was used as the outcome measure. The meta analysis showed that SMD=0.77, 95%CI=-0.05-1.58 (P＞0.05). Conclusion： There is a statistically significant difference between the swallowing training combined with the neuromuscular electrical stimulation therapy and the swallowing training only. There is no statistically significant difference between the neuromuscular electrical stimulation with swallowing training, the acupuncture, the electroacupuncture, or the electromyographic biofeedback respectively. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
