Evidence map›Paper›PMID 40959452›Full record

SynthesisFrontiers in pharmacology2025

Systematic review and meta-analysis of specific external Chinese herbal medicines for post-stroke dysphagia: efficacy and clinical implications.

Jingwen Zhang, Xingyu Kang, Jingwen Zhao, Jiajie Niu, Siyu Chen, Shuai Shi

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jingwen ZhangSecond Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.
Xingyu KangSecond Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.
Jingwen ZhaoSecond Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.
Jiajie NiuSecond Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.
Siyu ChenSecond Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.
Shuai ShiDepartment of Geriatrics II, The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To systematically evaluate the efficacy and safety of specific external traditional Chinese medicine therapies (SETCM therapies) versus conventional non-SETCM therapy interventions for improving swallowing function, nutritional status, and reducing complications in adult patients with post-stroke dysphagia (PSD), based on randomized controlled trials (RCTs). Methods: A comprehensive search was conducted from inception to present across Chinese [(China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Periodical Database (VIP), Wanfang Data Knowledge Service Platform (WFSD), Chinese Biology Medicine Database (CBM)] and international databases (PubMed, Embase, Web of Science, and Cochrane Library). RCTs investigating validated SETCM therapy modalities (e.g., herbal patches, iontophoresis, compresses, and fumigation) for PSD were included. All herbal components were taxonomically validated using the Kew Medicinal Plant Names Service (MPNS). The control group received conventional therapy (rehabilitation, nursing, and medication). The experimental group received SETCM therapies alone or combined with conventional care. The risk of bias in eligible studies was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed using RevMan 5.4. Stratified subgroup analyses were conducted based on stroke lesion location (supratentorial vs. brainstem) and intervention type. Results: Twenty-five RCTs (n = 2,159 patients; SETCM therapies group = 1,152, control group = 1,007) were included. The meta-analysis demonstrated significantly greater benefits in the SETCM therapies group for: overall response rate (OR = 3.28, 95% CI [2.49, 4.31]); overall cure rate (OR = 2.36, 95% CI [1.84, 3.02]); water swallowing test (WST) score (MD = -0.65, 95% CI [-1.23, -0.06]); and SWAL-quality-of-life (SWAL-QOL) score (MD = 25.61, 95% CI [20.54, 30.67]). The SETCM therapies group also demonstrated superior results in videofluoroscopic swallow study (VFSS) scores, modified Barthel index (MBI), serum albumin (ALB), prealbumin (PA), gugging swallowing screen (GUSS), activities of daily living (ADL), and functional dysphagia scale (FDS) scores, nasogastric tube removal success rate, as well as lower Nutritional Risk Screening 2002 (NRS 2002) scores, reduced aspiration incidence, and shorter nasogastric tube indwelling time. Safety analysis (three studies) reported mild skin irritation (erythema and pruritus) in 2.1% of cases. Conclusion: SETCM therapies significantly improved swallowing function, nutritional status, and clinical outcomes in patients with PSD. Efficacy exhibited neuroanatomical specificity: Acupoints are preferred for cerebral hemisphere lesions, while herbal iontophoresis is the best choice for brainstem involvement. These findings support the integration of targeted SETCM therapies into PSD rehabilitation. However, the evidence is limited by methodological biases, necessitating high-quality RCTs for confirmation. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024599344.

Indexed as

deglutition disordersexternal traditional Chinese medicine therapiesstrokesystematic reviewtherapeutic efficacy

Identifiers

PMID40959452
PMCPMC12434097

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.