下颏抗阻力训练治疗吞咽障碍的效果——一项Meta分析  

The effect of chin tuck against resistance training for dysphagia:a Meta-analysis

作　　者：王晓茁 南海鸥[2] WANG Xiaozhuo;NAN Haiou(Inner Mongolia Medical University,School of Public Health,Hohhot 010110;The affiliate hospital of Inner Mongolia Autonomous Region,Hohhot 010017,China)

机构地区：[1]内蒙古医科大学,010017 [2]内蒙古医科大学附属医院,010030

出　　处：《中国老年保健医学》2023年第1期47-53,共7页Chinese Journal of Geriatric Care

摘　　要：目的 系统评价下颏抗阻力训练治疗吞咽障碍的效果。方法 应用计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、WanFang Data、中国知网(CNKI)、维普中文科技期刊数据库(VIP)、临床试验注册数据库。搜集下颏抗阻力训练治疗吞咽障碍的随机对照试验(RCT),检索时间为建库至2021年10月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.4软件进行Meta分析。结果 本研究共纳入9个RCT,包括493例患者。Meta分析结果显示:下颏抗阻力训练加传统疗法对患者吞咽功能(SMD=-4.31,95%CI-5.21~-3.41,P<0.01)、经口进食情况(SMD=2.05,95%CI 1.18~2.92,P<0.01)、心理状况(MD=5.36,95%CI 4.86~5.85,P<0.01)的改善优于只采用传统疗法的患者。在都进行传统疗法的基础上,与联合Shaker训练相比,联合下颏抗阻力训练改善患者吞咽功能的效果更佳(MD=-0.39,95%CI-0.45~-0.32,P<0.01)。进一步根据不同的治疗时间(2周、4周、6周)进行亚组分析结果显示,在治疗2周时下颏抗阻力训练联合传统疗法的效果优于Shaker联合传统疗法组(P<0.01),治疗4周、6周时两者差异无统计学意义(P=0.16)。结论 下颏抗阻力训练联合传统疗法训练可以改善患者的吞咽功能、经口进食情况和心理状况,疗效优于传统疗法,在治疗早期(2周)的疗效优于Shaker联合传统疗法。Objective To systematically review the effect of chin tuck against resistance in the treatment of dysphagia.Methods PubMed, The Cochrane Library, EMbase, Web of Science, Wanfang data, CNKI databases, VIP,and clinical trial registration database were electronically searched to collect randomized controlled trials(RCTs)of chin tuck against resistance in the treatment of dysphagia from the establishment of the database to October 2021.Two investigators independently screened literature, extracted data, and assessed the risk of bias of included studies, Meta-analysis was performed using RevMan 5.4 software. Results A total of 9 RCTs including 493 patients were included.Meta-analysis results showed that CTAR training had a significant effect on patients’ swallowing function(SMD=-4.31,95%CI-5.21~-3.41,P<0.01),and oral intake(SMD=2.05,95%CI 1.18~2.92,P<0.01),the psychological status(MD=5.36,95%CI 4.86~5.85,P<0.01),was better than that of patients only using traditional therapy.On the basis of traditional therapy, compared with adding Shaker, adding CTAR had better effect on improving patients’ swallowing function(MD=-0.39,95%CI-0.45~-0.32,P<0.01).Further subgroup analysis according to different treatment time(2weeks, 4weeks, 6weeks)showed that the effect of CTAR+ traditional therapy was better than that of Shaker+ traditional therapy group at 2 weeks of treatment(P<0.01).The difference between the two was not statistically significant(P=0.16).Conclusion CTAR combined with traditional therapy training can improve patients’ swallowing function, oral feeding situation and psychological status, and the curative effect is better than traditional therapy, and the curative effect in the early stage of treatment(2 weeks)is better than Shaker plus traditional therapy.

关 键 词：下颏抗阻力训练(CTAR) 吞咽障碍 康复训练 META分析 

分 类 号：R493[医药卫生—康复医学]