定穴熏蒸联合下颏抗阻力训练对脑卒中后阻塞性睡眠呼吸暂停患者口咽部形态及功能的影响研究  

Impact of Fixed Point Fumigation Combined with Chin Resistance Training on Morphology and Function of Oral Pharynx in Patients with Post-stroke OSA

作　　者：何俊[1] 黄亮[1] 朱金妹[1] 钱雪 言丽香[1] 焦素芹[1] 张丽霞[2] 王彤[2] HE Jun;HUANG Liang;ZHU Jin-mei;QIAN Xue;YAN Li-xiang;JIAO Su-qin;ZHANG Li-xia;WANG Tong(Rehabilitation Center,Dean Hospital of Changzhou,Changzhou 213000,China;Rehabilitation Medical Center,the People＇ s Hospital of Jiangsu Province,Nanjing 210000,China)

机构地区：[1]江苏省常州市德安医院康复中心,213000 [2]江苏省人民医院康复医学中心,江苏省南京市210000

出　　处：《实用心脑肺血管病杂志》2018年第5期52-56,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2017年江苏省科技发展计划项目(BE2017752);常州市2017年科技支撑计划项目(CE20175033);常州市第41批科研项目(2016373)

摘　　要：目的观察定穴熏蒸联合下颏抗阻力训练对脑卒中后阻塞性睡眠呼吸暂停(OSA)患者口咽部形态、功能恢复的影响。方法选取2016-12-20至2017-12-20常州市德安医院康复中心收治的脑卒中后OSA患者80例,采用随机数字表法分为对照组与观察组,每组40例。在脑卒中常规治疗与功能康复训练基础上,对照组患者针对OSA给予持续气道正压通气(CPAP)治疗,观察组患者针对OSA给予定穴熏蒸联合下颏抗阻力训练。比较两组患者治疗前和治疗12周后口咽部位形态指标、多导睡眠图(PSG)监测结果、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评分及Fugl-Meyer运动功能评估量表(FMA)评分,并观察观察组患者治疗期间不良反应发生情况。结果治疗期间,对照组中9例患者、观察组中2例患者中途退出研究。治疗前两组患者腭后距离、软腭长及舌后距离比较,差异无统计学意义(P>0.05);治疗后观察组患者腭后距离、舌后距离长于对照组,软腭长短于对照组(P<0.05)。两组患者治疗前后呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(LSaO_2)、平均动脉血氧饱和度(MSaO_2)及最长呼吸暂停时间比较,差异无统计学意义(P>0.05)。两组患者治疗前NIHSS评分、Barthel指数评分、FMA评分及治疗后NIHSS评分比较,差异无统计学意义(P>0.05);观察组患者治疗后Barthel指数评分和FMA评分高于对照组(P<0.05)。治疗期间观察组患者均未出现明显不良反应。结论定穴熏蒸联合下颏抗阻力训练可有效纠正脑卒中后OSA患者口咽部形态,提高患者自理能力,促进患者运动功能恢复,且安全性较高。Objective To investigate the impact of fixed point fumigation combined with chin resistance training on morphology and function of oral pharynx in patients with post-stroke OSA. Methods From 2016-12-20 to 2017-12-20,a total of 80 patients with post-stroke OSA were selected in the Rehabilitation Center,Dean Hospital of Changzhou,and they were divided into control group and observation group according to random number table,each of 40 cases. Based on conventional treatment and functional rehabilitation training for stroke,patients in control group received continuous positive airway pressure ventilation,while patients in observation group received fixed point fumigation combined with chin resistance training. Morphological parameter of oral pharynx,PSG monitoring results,NIHSS score,Barthel index and FMA score were compared between the two groups before and after treatment,and incidence of adverse reactions in observation group was observed during treatment. Results During treatment,9 cases in control group and 2 cases in observation group withdrew midway. No statistically significant differences of posterior palatal distance,soft palate length or posterior lingual distance was found between the two groups before treatment（P〈0.05）;after treatment,posterior palatal distance and posterior lingual distance in observation group were statistically significantly longer than those in control group,while soft palate length in observation group was statistically significantly shorter than that in control group（P〈0.05）. No statistically significant differences of AHI,LSaO2,MSaO2 or the longest apnea time was found between the two groups before or after treatment（P〈0.05）. No statistically significant differences of NIHSS score,Barthel index score or FMA score was found between the two groups before treatment,nor was NIHSS score after treatment（P〈0.05）,while Barthel index score and FMA score in observation group were statistically significantly higher than those in control group after treatment（P〈0.

关 键 词：卒中 睡眠呼吸暂停 阻塞性 定穴熏蒸 下颏抗阻力训练 治疗结果 

分 类 号：R743[医药卫生—神经病学与精神病学] R563.8[医药卫生—临床医学]