不同频率电针廉泉、风府穴治疗中风吞咽障碍临床研究  

Clinical study of electroacupuncture with different frequencies at Lianquan(CV 23) and Fengfu(GV 16) for stroke dysphagia

作　　者：张立志 许能贵 李如良[2] 王琳 

机构地区：[1]广州中医药大学针灸康复临床医学院华南针灸研究中心,广东广州510405 [2]武警广东总队医院

出　　处：《中国针灸》2018年第2期115-118,共4页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金重点项目:81230088;广东省青年创新人才项目:2016 KQNCX 027

摘　　要：目的:在西医内科治疗及常规康复训练基础上,观察不同频率电针治疗中风吞咽障碍的临床疗效差异。方法:将符合纳入标准的60例中风吞咽障碍患者随机分为低频(2 Hz)组与高频(100 Hz)组,每组30例。两组均行基础治疗,穴取风府、廉泉,电针采用连续波,频率分别为2、100 Hz,刺激强度以患者可耐受为度,每日1次,每次留针30 min,连续治疗14 d。主要评定指标为电视X线透视吞咽功能(VFSS),检查口腔期通过时间、咽期延迟时间、咽期通过时间,次要评定指标为洼田饮水试验评级、标准吞咽功能评定量表(SSA)评分,并评价临床疗效。结果:电针后,两组患者口腔期通过时间、咽期延迟时间、咽期通过时间均较治疗前减少(均P<0.05),且低频组均少于高频组(均P<0.05),两组患者洼田饮水试验分级均较本组电针治疗前改善(均P<0.05),且低频组优于高频组(P<0.05),两组治疗后SSA评分均较治疗前下降(均P<0.05),低频组治疗后SSA评分改善情况优于高频组(P<0.05),电针治疗后,低频组与高频组的总有效率分别为93.3%(28/30)、66.7%(20/30),差异有统计学意义(P<0.05),结论:低频电针改善中风后吞咽功能的疗效优于高频电针。Objective To observe the effects of electroacupuncture（EA） with different frequencies based on the western conventional treatment and rehabilita tion training for stroke dysphagia. Methods Sixty patients with dysphagia after stroke were randomized assigned into a low frequency（2 Hz） group and a high frequency（100 Hz） group, 30 cases in each one. Basic treatment was applied in the two groups. The acupoints were Fengfu（GV 16） and Lianquan（CV 23）. EA with continuous wave and tolerant intensity were connected for 30 min, once a day for 14 days. The main index was video fluoroscopic swallowing study（VFSS） to detect passing time at oral stage, pharynx delay time at pharyngeal stage, passing time at pharynx stage. The second indexes were water swallow test rating and standardized swallowing assessment（SSA）. The clinical effect was evaluated. Results After treatment, the passing time at oral stage, pharynx delay time at pharyngeal stage, passing time at pharynx stage were lower than those before treatment in the two groups（all P 0.05）, and the results in the low frequency group were better（all P 0.05）. After treatment, the water swallow test rating improved in the two groups（both P0.05）, and that in the low frequency group was better（P0.05）. The SSA score decreased in the two groups（both P0.05）, and the improvement in the lower frequency group was superior to that in the high frequency group（P0.05）. The total effective rate in the low frequency group was 93.3%（28/30）, which was better than 66.7%（20/30） in the high frequency group（P0.05）.Conclusion The effect of EA with lower frequency is better than that of EA with higher frequency for stroke dysphagia.

关 键 词：中风后吞咽障碍 电针 不同频率 穴 风府 穴 廉泉 

分 类 号：R246.6[医药卫生—针灸推拿学]