Effect of comprehensive swallowing training on stroke-related pneumonia Meta-analysis

doi:10.3877/cma.j.issn.1674-6902.2019.02.011

Abstract

Abstract:

Objective

To evaluate the effect of comprehensive swallowing training on the stroke-associated pneumonia.

Methods

A computer-based search of PubMed, CBM, VIP and CNKI was conducted for randomized controlled trials (RCTs) for the effect of comprehensive swallowing trainings on the incidence of post-stroke-associated pneumonia. The search period was from the establishment of the database to March 31, 2018. Two researchers screened the literatures according to the inclusion and exclusion criteria. They extracted the data, evaluated the quality, and then used RevMan5.3 software to perform Meta analysis or only descriptive analysis.

Results

A total of 994 patients were included in 9 RCTs. The results of Meta analysis showed that the incidence of SAP in the comprehensive swallowing training group was significantly lower than that in the conventional swallowing training group [RR=0.42, 95%CI (0.31, 0.56), P<0.001]. The score of dysphagia was improved [SMD=-1.25, 95%CI (-1.48, -1.01), P<0.001], and the curative effect of the patients with dysphagia was increased [RR=1.22, 95%CI (1.13, 1.32), P<0.001].

Conclusion

The intervention of comprehensive swallowing training can reduce the incidence of SAP, improve the score of swallowing function and improve the clinical efficacy of dysphagia.

Key words: Stroke, Dysphagia, Comprehensive swallowing training, Pneumonia, Meta-analysis

Ying Fang, Yu Xue, Li Chen, Dan Luo, Chaoqiong Liu, Yan Jin. Effect of comprehensive swallowing training on stroke-related pneumonia Meta-analysis[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(02): 187-191.

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Figures/Tables 6

References 16

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作　者	例　数		干预措施		干预时间	随访时间	结局指标
作　者	干预组	对照组	干预组	对照组	干预时间	随访时间	结局指标
曹清莲(2014)^[5]	103	103	运动想象疗法＋常规康复护理	常规康复护理	6周	6周	①
程富香(2014)^[6]	60	60	针刺廉泉穴治疗＋常规吞咽康复训练	常规吞咽康复训练	4周	4周	①②③
刘　波(2016)^[7]	30	30	针刺结合雷火灸＋吞咽障碍治疗仪＋吞咽训练方法治疗	吞咽训练方法治疗	4周	4周	①②③
李坤彬(2014)^[8]	46	46	冰刺激治疗＋常规治疗、吞咽康复训练	常规治疗、吞咽康复训练	14 d	14 d	①③
丁　玲(2013)^[9]	50	48	吞咽治疗仪＋电针治疗＋基础咽功能训练、进食训练	基础咽功能训练、进食训练	1个月	1个月	①③
金晓红(2017)^[10]	36	36	吞咽治疗仪＋综合康复训练	常规吞咽功能训练、常规护理	4周	4周	①②③
吴灵君(2015)^[11]	54	53	运动想象联合＋电刺激＋吞咽康复功能锻炼	基础吞咽康复功能锻炼	6周	6周	②③
Ciselle(2005)^[12]	102	102	高强度行为干预	常规康复训练	6个月	6个月	①
Kim(2017)^[13]	18	17	TPRT＋传统吞咽困难治疗	传统吞咽困难治疗	4周	4周	②

作　者	例　数		干预措施		干预时间	随访时间	结局指标
作　者	干预组	对照组	干预组	对照组	干预时间	随访时间	结局指标
曹清莲(2014)^[5]	103	103	运动想象疗法＋常规康复护理	常规康复护理	6周	6周	①
程富香(2014)^[6]	60	60	针刺廉泉穴治疗＋常规吞咽康复训练	常规吞咽康复训练	4周	4周	①②③
刘　波(2016)^[7]	30	30	针刺结合雷火灸＋吞咽障碍治疗仪＋吞咽训练方法治疗	吞咽训练方法治疗	4周	4周	①②③
李坤彬(2014)^[8]	46	46	冰刺激治疗＋常规治疗、吞咽康复训练	常规治疗、吞咽康复训练	14 d	14 d	①③
丁　玲(2013)^[9]	50	48	吞咽治疗仪＋电针治疗＋基础咽功能训练、进食训练	基础咽功能训练、进食训练	1个月	1个月	①③
金晓红(2017)^[10]	36	36	吞咽治疗仪＋综合康复训练	常规吞咽功能训练、常规护理	4周	4周	①②③
吴灵君(2015)^[11]	54	53	运动想象联合＋电刺激＋吞咽康复功能锻炼	基础吞咽康复功能锻炼	6周	6周	②③
Ciselle(2005)^[12]	102	102	高强度行为干预	常规康复训练	6个月	6个月	①
Kim(2017)^[13]	18	17	TPRT＋传统吞咽困难治疗	传统吞咽困难治疗	4周	4周	②

作　者	随机分配方法	分配方案隐藏	盲法	退出、失访报道	ITT分析	基线	质量等级
曹清莲(2014)^[5]	充分	不清楚	不清楚	未报道	未采用	是	C级
程富香(2014)^[6]	充分	是	不清楚	未报道	未采用	是	B级
刘　波(2016)^[7]	不清楚	不清楚	单盲	报道	未采用	是	B级
李坤彬(2014)^[8]	充分	不清楚	不清楚	未报道	未采用	是	C级
丁　玲(2013)^[9]	不清楚	不清楚	不清楚	未报道	未采用	是	C级
金晓红(2017)^[10]	不清楚	不清楚	不清楚	未报道	未采用	是	C级
吴灵君(2015)^[11]	充分	不清楚	单盲	未报道	未采用	是	B级
Ciselle(2005)^[12]	充分	是	单盲	报道	采用	是	A级
Kim(2017)^[13]	充分	不清楚	不清楚	报道	未采用	是	C级

作　者	随机分配方法	分配方案隐藏	盲法	退出、失访报道	ITT分析	基线	质量等级
曹清莲(2014)^[5]	充分	不清楚	不清楚	未报道	未采用	是	C级
程富香(2014)^[6]	充分	是	不清楚	未报道	未采用	是	B级
刘　波(2016)^[7]	不清楚	不清楚	单盲	报道	未采用	是	B级
李坤彬(2014)^[8]	充分	不清楚	不清楚	未报道	未采用	是	C级
丁　玲(2013)^[9]	不清楚	不清楚	不清楚	未报道	未采用	是	C级
金晓红(2017)^[10]	不清楚	不清楚	不清楚	未报道	未采用	是	C级
吴灵君(2015)^[11]	充分	不清楚	单盲	未报道	未采用	是	B级
Ciselle(2005)^[12]	充分	是	单盲	报道	采用	是	A级
Kim(2017)^[13]	充分	不清楚	不清楚	报道	未采用	是	C级

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