Acupuncture For Dysphagia After Stroke:A Systematic Review

Objective:To objectively evaluate the efficacy and security of acupuncture for dysphagia by systematic review.Method:1. The inclusion and exclusion criteriaRCTs in which acupuncture is the main treatment for swallowing disorders after stroke were included. But in a same trail, different acupuncture methods or selecting points were excluded.2. Search strategySearching CBM, CNKI, Wanfang Database, VIP, Cochrane Library, PubMed, along with manual retrieval and supplement retrieval acording to the inclusion and exclusion criteria with characteristics of databases.3. Data collection and analysisData collection and assessment of risk of bias were independently completed by two researchers. We used review manager5.2 to analyze data, chose OR and WMD for binary and continuous outcomes respectively.4. Rating the quality of evidenceGRADE was used to evaluate the quality of evidence in study limitations, inconsistency, indirectness, imprecision and publication bias.Results:1.17 trials were included, involving 1440 participants with swallowing disorders, which 728 cases were in treatment group and 712 cases were in control group.2. Acupuncture combined with routine medical treatment was more effective than routine medical therapy [OR 17.25,95%CI (6.83,43.56)], they had a same effect in improving Watian swallowing ability [WMD 0.52,95%CI (-0.80,1.84)], GRADE as "very low".3. Compared with routine medical treatment combined with rehabilitation, acupuncture combined with routine medical treatment and rehabilitation was more effective in improving Watian swallowing ability [WMD-0.37,95%CI (-0.54, 0.20)], the dysphagia score [WMD 1.57,95%CI (1.29,1.85)] and VFFS score [WMD 1.50,95% CI (0.49,2.52)].4. Compared with rehabilitation alone, acupuncture combined with rehabilitation was more effective [OR 3.65,95%CI(1.64,8.15)], GRADE as "very low".5. Acupuncture and rehabilitation had a same effect in improving Watian swallowing ability [WMD-0.40,95%CI(-1.02,0.22)], VFFS score [WMD 1.23, 95%CI(-0.25,2.71)] and reducing the rate of aspiration pneumonia [OR 0.56,95%CI (0.25,1.26)].6. As all the trials were different in selecting points and acupuncture methods, and rehabilitation, it’s difficult to summarize a prioritization scheme.Conclusion:1. Compared with routine medical treatment, acupuncture combined with routine medical treatment was more effective. They had a same effect in improving Watian swallowing ability.2. Compared with routine medical treatment combined rehabilitation, acupuncture combined with routine medical treatment and rehabilitation was more effective in improving Watian swallowing ability, the dysphagia score and VFFS score.3. Compared with rehabilitation alone, acupuncture combined with rehabilitation was more effective.4. Acupuncture and rehabilitation had a same effect in improving Watian swallowing ability, VFFS score and reducing the rate of aspiration pneumonia.