Efficacy of acupuncture for dysphagia after stroke: a systematic review and meta-analysis

Background: The risk of dysphagia after stroke is extremely high. The efficacy of acupuncture in the treatment of dysphagia after stroke lacks high-level evidence-based medical support. This study aimed to systematically evaluate the clinical value of acupuncture therapy in patients with dysphagia after stroke. Methods: A electronic search of six databases were used to screen for randomized controlled trials (RCTs) of acupuncture treatment of patients with dysphagia after stroke. The search time was from the establishment of the database to 18 October 2020, and the search languages were limited to Chinese and English. The literature was screened and the data extracted independently by two researchers. The Cochrane System Evaluation Manual was used to evaluate the quality of the included literature. Results: A total of 39 RCTs were included, of which 36 studies reported the effective rate of acupuncture treatment for dysphagia. The effective rate of the experimental group was higher than that of the control group [relative risk (RR) =1.23, 95% confidence interval (CI): 1.19 to 1.27, P<0.00001]. The drinking test grading score of patients in the experimental group was lower than that of the control group [mean difference (MD) =-0.75, 95% CI: -1.11 to -0.41, P<0.0001] in 8 studies. The swallowing scores of patients in the experimental group were lower than those in the control group (MD =-4.63, 95% CI: -5.68 to -3.59, P<0.00001) in 8 studies. The Fujishima eating-swallowing rating score of the experimental group was higher than that of the control group [standardized mean difference (SMD) =1.92, 95% CI: 1.30 to 2.54, P<0.00001] in 3 studies. The score of the dysphagia-specific quality of life scale of the experimental group was higher than that of the control group (SMD =2.02, 95% CI: 0.82 to 3.22, P=0.0001) in 5 studies. The VFSS of the experimental group was higher than that of the control group (MD =2.53, 95% CI: 1.89 to 3.17, P<0.00001) in 5 studies. Conclusions: The existing evidence supports that acupuncture therapy can significantly improve the swallowing function of patients with dysphagia.