电针及点刺放血治疗脑卒中后吞咽障碍临床观察  

Clinical Observation of Electroacupuncture plus Pricking Bloodletting for Deglutition Disorder After Cerebral Stroke

作　　者：陈捷 宿翀[2] 

机构地区：[1]北京市中关村医院,北京100190 [2]北京化工大学信息科学与技术学院,北京100029

出　　处：《上海针灸杂志》2017年第6期657-662,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(61603023);北京市优秀人才培养资助项目(2015000020124G041)

摘　　要：目的研究电针及点刺放血治疗脑卒中后吞咽障碍的有效性。方法将84例患者随机分为治疗组和对照组,每组42例。治疗组采用电针及点刺放血加康复训练,对照组采用康复训练。通过治疗2个疗程和治疗6个月以后洼田饮水疗效判断和临床床旁评估量表的分数观察两组短期和长期疗效。通过观察治疗前后临床床旁评估量表分数变化,分析电针及点刺放血对于治疗吞咽障碍的一些症状体征的疗效。结果治疗组总有效率为90.5%,对照组总有效率为54.8%,两组比较差异有统计学意义(P<0.01)。治疗2个疗程和治疗6个月后治疗组患者的洼田饮水疗效判断分数均优于对照组(P<0.05)。治疗2个疗程和治疗6个月后治疗组患者的临床床旁评估量表的分数均优于对照组(P<0.05)。两组患者洼田饮水疗效判断分数和临床床旁评估量表的分数均优于治疗前(P<0.05)。通过观察治疗组近期、远期临床床旁评估量表分数变化发现,电针及点刺放血对于临床床旁评估量表中喉功能的改善,咽反射的改变,自主咳嗽、喉运动、吞咽时咳嗽的分数改变,无论近期还是远期与治疗前比较差异均有统计学意义(P<0.05)。结论临床观察表明,电针及点刺放血刺激能够治疗脑卒中后吞咽障碍,且近期和远期疗效都显著。电针及点刺放血治疗脑卒中后吞咽障碍之后针对口期、咽期症状和体征具有良好的改善作用。Objective To study the effectiveness of electroacupuncture plus bloodletting in treating deglutition disorder after cerebral stroke. Method Eighty-four patients were randomized into a treatment group and a control group, 42 cases in each group. The treatment group was intervened by electroacupuncture plus bloodletting and rehabilitation training, while the control group was intervened by rehabilitation training. After 2 treatment courses and 6 months after the treatment, Kubota＇s water drinking test and clinical bedside assessment were evaluated to measure the short-term and long-term therapeutic efficacies. By observing the change of clinical bedside assessment score, the effect of electroacupuncture plus bloodletting on certain symptoms of deglutition disorder was analyzed. Result The total effective rate was 90.5% in the treatment group versus 54.8% in the control group, and the between-group difference was statistically significant （P〈0.01）. Respectively after 2 treatment courses and 6 months after the intervention, the drinking water test scores in the treatment group were superior to those in the control group （P〈0.05）. The bedside assessment scores in the treatment group were better than those in the control group respectively after 2 treatment courses and 6 months after the intervention （P〈0.05）. Post-treatment water drinking and bedside assessment scores were significantly better than pre-treatment scores in both groups （P〈0.05）. According to the observation of short-term

关 键 词：电针 吞咽障碍 中风并发症 洼田饮水试验 临床床旁评估量表 点刺 

分 类 号：R246.6[医药卫生—针灸推拿学]