J Oral Rehabil:口部运动练习和感觉刺激对神经源性吞咽障碍的治疗效果如何?

2022-01-18 MedSci原创 MedSci原创

吞咽障碍的康复治疗,包括口部运动练习和感觉刺激,已广泛采用于临床实践。然而,目前仅有探索性研究支持这些治疗方法的效果,因此,这些疗法的真正临床疗效仍不确定。近日,发表于J Oral Rehabil的一

吞咽障碍的康复治疗,包括口腔运动练习和感觉刺激,已广泛用于临床实践。然而,目前仅有探索性研究支持这些康复治疗方法的效果,因此,这些疗法的真正临床疗效仍不确定。近日,发表于J Oral Rehabil的一项系统回顾和荟萃分析评估了基于随机对照试验(RCTs)证据的康复疗法对神经源性吞咽障碍的疗效。

1970年1月至2021年7月期间研究人员系统地搜索了六个电子数据库。数据由两名独立审查员进行提取和分析。结果衡量标准是(任何)相关临床吞咽相关特征的变化。

结果,研究人员从8项RCT研究中收集了285名吞咽困难患者的数据,包括一系列吞咽困难治疗疗法。分析结果显示,与对照组相比,所有口内吞咽困难治疗的集合效应大小不明显(SMD[95%CI]=0.23[-0.22, 0.69],p=0.31;I2=73%)。亚组分析显示,口部运动练习(设备辅助的唇部阻力练习和舌头练习)(SMD [95%CI] = 0.11 [-0.76, 0.97]; p = .81; I2 = 88%)和感觉刺激(热-触觉、热-化学和电刺激)(SMD [95%CI] = 0.35 [-0.03, 0.72]; p = .07; I2 = 0%)的集合效应大小也不显著。

综上所述,该研究结果表明,吞咽困难的治疗方法,包括口内运动锻炼和感觉刺激,对神经源性吞咽困难没有显示出有益的效果。这些治疗方法的证据仍然薄弱,目前不足以支持临床使用。未来需要有更多标准化的吞咽评估结果和适当的不良反应记录的大规模、多中心临床试验,以全面评估其治疗神经源性吞咽障碍的疗效。

原始出处:

Ivy Cheng, et al., A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia. J Oral Rehabil. 2022 Jan;49(1):92-102. doi: 10.1111/joor.13274.

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    2022-03-08 小几洁
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    2022-01-20 qjddjq

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