Background:Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview.Methods:Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results:Nine SRs/MAs were included in this study. For methodological quality, what resulted in unsatisfactory methodological quality was noncompliance with critical item 4 (using a comprehensive literature search strategy) and critical item 7 (providing the list of excluded research literature). For reporting quality, what resulted in unsatisfactory reporting quality was inadequate reporting of Q1 (protocol and registration), Q8 (search), Q15 (risk of bias across studies), Q16 (additional analyses), Q22 (risk of bias across studies), Q23 (additional analysis), and Q27 (funding). For GRADE, the evidence quality was high in 0, moderate in 3, low in 11, and very low in 6. Risk of bias was the most common factor leading to downgrading of evidence, followed by inconsistency, imprecision, publication bias, and indirectness.Conclusions:TC may have beneficial effects on balance function in stroke survivors; however, this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs.

Background An increasing number of systematic reviews/meta-analyses (SRs/MAs) of clinical trials have begun to investigate the effects of traditional Chinese medicine (TCM) nursing in patients with stroke. To systematically appraise and synthesize these results, we conducted an overview of SRs/MAs. Methods Eight databases from their inception to April 2020 were searched to include all SRs/MAs on TCM nursing for stroke. Methodological quality assessment was performed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and evidence quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Eleven SRs/MAs regarding TCM nursing for stroke were included. The assessments with AMSTAR-2 indicated that the methodological quality of all included SRs/MAs was critically low. According to the evaluation results of GRADE, 10 (40%) outcomes were rated as critically low-quality evidence, 7 (28%) low-quality evidence, and 8 (32%) moderate-quality evidence. Descriptive analysis results showed that TCM nursing was effective for stroke. Conclusions All included SRs/MAs suggested positive findings of TCM nursing for stroke, but the credibility of the results is limited. Studies with methodologically rigorous and adequately powered are still needed in this field.

Abstract Background Dysphagia is common after stroke. Patients with dysphagia have a higher risk of stroke-associated pneumonia (SAP) and poor outcomes. Early detection of dysphagia is necessary to identify and manage patients at high risk of aspiration. The aim of the study was to assess the impact of the systematic administration of the volume-viscosity swallow test (V-VST) in patients with acute ischaemic stroke. Methods This was a retrospective observational study that enrolled patients with acute ischaemic stroke in two consecutive time periods: pre-V-VST, when the 30-mL water-swallowing test (WST) was systematically administered, and V-VST, when all patients underwent the WST and the V-VST test was systematically administered if the patient failed the WST. Results Two hundred and 42 patients were enrolled. The mean age of the participants was 68.8 ± 10.88 years, 61.2% were male, and the median National Institutes of Health Stroke Scale score was 3 (IQR, 1–6). A total of 147 patients were enrolled during the pre-V-VST period and 95 were enrolled during the V-VST period. There was a significant difference in the occurrence of SAP (21.8% vs. 10.5%, p = 0.024) and the rate of nasogastric tube feeding (25.9% vs. 14.7%, p = 0.040) between the two groups, and no differences were found in the length of hospital stay (p = 0.277) or the total cost of hospitalization (p = 0.846). Conclusions The V-VST was a better clinical screening tool, and it can also provide detailed suggestions regarding dietary modifications to prevent aspiration and SAP.

目的 分析连续护理干预对脑卒中吞咽障碍患者吞咽功能恢复的影响.方法 回顾性分析2018年9月1日至2019年3月1日我院收治50例脑卒中吞咽功能障碍患者的数据资料,其中25例患者采取常规护理(对照组),25例患者采取连续护理干预(干预组),对比两组患者护理效果.结果 ①护理前两组患者吞咽功能评分比较并无差异(P>0.05);护理后干预组患者吞咽功能评分低于对照组患者,数据差异显著(P<0.05).②护理前两组患者NIHSS评分比较并无差异(P>0.05);护理后干预组患者NIHSS评分低于对照组患者,数据差异显著(P<0.05).结论 连续护理干预在脑卒中吞咽障碍中有着重要的意义,有效的促进吞咽功能的恢复,更利于患者预后,值得推广使用.

目的 探讨中药穴位贴敷对改善急性脑梗死患者睡眠质量的效果.方法 回顾性分析2017年11月～2018年7月在我科住院治疗的81例急性脑梗死患者的临床资料,根据护理方案不同分为对照组(40例)和观察组(41例);对照组采用常规护理方案干预,观察组在对照组的基础上进行中药穴位贴敷治疗干预,运用匹兹堡睡眠质量指数(PSQI)评价两组患者的睡眠质量变化情况.结果 干预前两组患者PSQI的总分和各维度评分比较无统计学差异(P>0.05),干预后两组患者PSQI的各项评分均有所降低,且观察组降低程度明显优于对照组,差异具有统计学意义(P<0.05).结论 中药穴位贴敷能明显改善急性脑梗死患者的睡眠状况,提高睡眠质量,且操作简便、安全性好,值得临床推广.

目的:探讨祛风化痰、活血通络法联合耳穴压豆治疗风痰上扰夹瘀型脑卒中后失眠症的临床效果.方法:将85例风痰上扰夹瘀型脑卒中后失眠症患者随机数表法分为观察组(n=45)和对照组(n=40).对照组予西药联合耳穴压豆,观察组予祛风化痰、活血通络法联合耳穴压豆治疗.观察两组临床疗效、夜间睡眠时间,治疗前后以匹兹堡睡眠质量指数(PSQI)量表评定睡眠质量,Barthel指数评分评估日常生活能力,并评估安全性.结果:观察组临床总有效率显著高于对照组(P<0.05).治疗后观察组夜间睡眠时间>6 h的患者比例显著高于对照组,<3 h的患者比例显著低于对照组(P<0.05).治疗后两组PSQI评分、Barthel指数评分有显著差异(P<0.05).两组不良反应比较无统计学意义(P>0.05).结论:祛风化痰、活血通络法联合耳穴压豆治疗风痰上扰夹瘀型脑卒中后失眠症的临床疗效显著,可延长夜间睡眠时间,改善睡眠质量,提高日常活动能力.

脑梗塞合并糖尿病是临床护理中常见的病种。本文从中医角度探讨其中医施护方法，重点阐述了脑梗塞合并糖尿病的情志护理、饮食护理和康复指导方法。