生物反馈治疗脑卒中后吞咽障碍疗效的Meta分析  

Treating post-stroke dysphagia with biofeedback:A meta-analvsis

作　　者：董旭 李壮苗[1] 吴燕华 Dong Xu;Li Zhuangmiao;Wu Yanhua(College of Nursing,Fujian Unirersity of Traditional Chinese Medicine,Fuzhou 350122,China)

机构地区：[1]福建中医药大学,350122

出　　处：《中华物理医学与康复杂志》2019年第3期227-233,共7页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的评价生物反馈治疗脑卒中后吞咽障碍患者的疗效。方法计算机检索PubMed、Cochrane图书馆、EMbase、Web of Science、中国生物医学数据库、万方数据库、中国知网及维普数据库,检索时限为建库至2018年12月31日。采用RevMan5.3软件对数据进行Meta分析。结果共纳入17项研究,1306例患者。Meta分析结果显示,在治疗总有效率[相对危险度(RR)=1.29,95%置信区间(CI)为(1.20,1.38),P<0.00001]、功能性经口摄食量表(FOIS)[均数差(MD)=0.81,95%CI(0.39,1.24),P=0.0002]、标准吞咽功能评价量表(SSA)[MD=-5.83,95%CI(-8.48,-3.17),P<0.0001]、吞咽障碍特异性生活质量量表(SWAL-QOL)[MD=18.80,95%CI(15.74,21.86),P<0.00001]、吸入性肺炎[RR=0.46,95%CI(0.26,0.82),P=0.008]方面,治疗组均优于对照组(P<0.05)。结论生物反馈治疗能较好地改善脑卒中后吞咽障碍患者的吞咽功能及生活质量、降低肺炎发生率并提高摄食水平,但尚需进一步更多高质量、大样本的随机对照试验(RCT)加以验证。ObjectiveTo evaluate the effect of treating post-stroke dysphagia with biofeedback.MethodsPubMed,the Cochrane library,EMbase,the Web of Science,the Chinese biomedical database,the Wanfang database,the China national knowledge infrastructure and the VIP database were searched for reports of randomized and controlled trials(RCTs)of biofeedback for treating post-stroke dysphagia.The search covered the period from each database′s inception to December 31,2018.Version 5.3 of the RevMan software was used to analyze the data.ResultsA total of 17 studies were included,covering 1306 patients.The meta-analysis showed that the intervention group was significantly better than the control group in terms of the total effectiveness rate,the average Functional Oral Intake Scale score,and scores on the Standardized Swallowing Assessment and on the Swallowing Quality-of-Life Questionnaire.The incidence of aspiration pneumonia was also significantly lower in the biofeedback treatment group.ConclusionBiofeedback can be applied to improve swallowing,the level of ingestion and the quality of life of stroke survivors.It can also reduce the incidence of pneumonia.More high-quality RCTs with large samples are needed to further verify these conclusions.

关 键 词：脑卒中 吞咽障碍 生物反馈 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]