肌电引导下人迎穴穴位注射治疗脑卒中后吞咽困难疗效观察  

Electromyography guided point injection at Renying(ST 9) for post-stroke dysphagia

作　　者：尚妍 任红[1] 刘福兴[2] 石钰[1] 王佩[2] 邸雪琴 SHANG Yan;REN Hong;LIU Fuxing;SHI Yu;WANG Pei;DI Xueqin(Department of Rehabilitation;Department of Neurology;Department of Elecrrocardiogram,Baoding First Central Hospital,Baoding 071000,Hebei Province,China)

机构地区：[1]保定市第一中心医院康复科,河北保定071000 [2]保定市第一中心医院神经内科,河北保定071000 [3]保定市第一中心医院心电脑电图室,河北保定071000

出　　处：《中国针灸》2018年第8期803-806,共4页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察肌电引导下人迎穴穴位注射治疗脑卒中后延髓麻痹所致吞咽困难的治疗效果,探寻在常规药物和康复训练基础上提高吞咽功能的有效疗法。方法:将60例脑卒中后延髓麻痹所致吞咽困难患者随机分为观察组和对照组,每组30例。对照组采用常规脑卒中药物结合康复训练疗法,每日1次;观察组在对照组的基础上加肌电引导下人迎穴穴位注射疗法,每周3次,两组均治疗2周。观察两组患者治疗前后藤岛一郎吞咽疗效评分及洼田饮水试验评分,并评定两组疗效。结果:两组治疗后藤岛一郎吞咽评分较治疗前升高,洼田饮水试验评分较治疗前降低(均P<0.05),且变化幅度观察组较对照组显著(均P<0.05);观察组吞咽疗效总有效率为93.3%(28/30),治愈率为46.7%(14/30),优于对照组的26.7%(8/30,P<0.05)和3.3%(1/30,P<0.05)。结论:在常规药物和康复训练基础上,肌电引导下人迎穴穴位注射可有效改善脑卒中后延髓麻痹所致吞咽困难患者的吞咽功能。ABSTRACT Objective To observe the effect of electromyography （EMG） guided point injection at Renying （ST 9） for post-stroke dysphagia caused by bulbar paralysis, anti explore effective treatments for improving swallowing function on the basis of conventional medicine and rehabilitation training. Methods A total of 60 patients were randomly divided into an observation group and a control group, 30 cases in each one. The conventional dnlgs combined with rehabilitation training were given in the control group, the treatment was given once every, day. Based on the treatment in the control group, the EMG guided point injection at Renying （ST 9） was added in the observation group, three times a week. All the treatment was given for 2 weeks. WaTian drinking test score and Toshima Ichiro swallow test score were observed before and after treatment in the two groups, and the effects were assessed. Results Toshima Ichiro swallow test score increased after treatment in both groups compared with that before treatment, and WaTian drinking test score decreased compared with that before treatment （all P〈 0.05）, and the change rate in the observation group was significantly hetter than that in the control group （both P〈 0.05）. The total effective rate of swallowing efficacy in the observation group was 93.3% （28/30）, and the cured rate was 46.7% （14/30）, which were better than 26.7% （8/30） and 3.3% （1/30） in the control group （both P〈 0.05）. Conclusion On the basis of conventional drugs and rehabilitation training, the EMG guided point injection at Renying （ST 9） can effectively increase the swallowing function of patients with post-stroke dysphagia caused by bulbar paralysis.

关 键 词：延髓麻痹 吞咽困难 肌电 穴 人迎 藤岛一郎吞咽疗效评价评分 洼田饮水试验评分 

分 类 号：R246.6[医药卫生—针灸推拿学]