针灸结合咽部冰刺激训练治疗脑卒中后吞咽障碍临床研究  

Clinical study on the treatment of dysphagia after stroke with acupuncture combined with pharyngeal ice stimulation

作　　者：李媛 赵正恩 张少军[1] 汪玲[1] 赵利 邓佩琳 张锐 吴涛[2] LI Yuan;ZHAO Zhengen;ZHANG Shaojun(Rehabilitation Department,Mianzhu People’s Hospital in Sichuan Province,Mianzhu 618200)

机构地区：[1]四川省绵竹市人民医院康复科,绵竹618200 [2]四川大学华西医院康复医学科,成都610041

出　　处：《陕西中医》2020年第2期238-240,257,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省医学会青年创新课题(Q18045)

摘　　要：目的:观察中医针灸结合咽部冰刺激训练治疗脑卒中后吞咽障碍的疗效。方法:选择150例脑卒中患者为研究对象,以随机数字表法分为对照组和观察组,各75例,前者给予基础治疗、口腔训练和咽部冰刺激训练,后者在前者治疗基础上予以针灸,比较两组疗效、吞咽功能、表面肌电图(sEMG)、舌骨喉复合体动度及安全性。结果:观察组治疗有效率高于对照组(P<0.05);治疗后,观察组SSA评分低于对照组(P<0.05),VFSS评分高于对照组(P<0.05),sEMG最大波幅值大于对照组(P<0.05),吞咽时程短于对照组(P<0.05),舌骨喉复合体动度均大于对照组(P<0.05)。对照组未见不良反应,观察组有2例患者出现针刺部位红肿,冷敷后红肿消退,未见其他不良反应。结论:中医针灸结合咽部冰刺激训练治疗脑卒中后吞咽障碍疗效较好,能显著改善患者吞咽功能。Objective:To observe the curative effect of traditional Chinese medicine(TCM)acupuncture combined with pharyngeal ice stimulation in the treatment of dysphagia after stroke.Methods:150 patients with stroke were selected as the study subjects.They were divided into the control group and the observation group by random number table method with 75 cases in each group.The former group were given basic treatment,oral training and pharyngeal ice stimulation.On this basis,the latter group were treated with TCM acupuncture.The curative effect,swallowing function,surface electromyogram(sEMG),mobility of the hyoid complex and safety were compared between the two groups.Results:The response rate of observation group was higher than that of the control group(P<0.05).After treatment,the SSA score of the observation group was lower than that of the control group while the VFSS score was higher than the control group(P<0.05).The maximum amplitude of sEMG was greater than the control group(P<0.05),the swallowing time was shorter than the control group(P<0.05),and the mobility of the hyoid complex was greater than the control group(P<0.05).No adverse reactions were observed in the control group.Two patients in the observation group had redness and swelling at the acupuncture site.After cold compress,redness and swelling subsided,and no other adverse reactions were observed.Conclusion:TCM acupuncture combined with pharyngeal ice stimulation is effective in the treatment of dysphagia after stroke.The combined treatment can significantly improve the swallowing function of patients.

关 键 词：脑卒中 针灸 咽部冰刺激训练 吞咽障碍 表面肌电图 

分 类 号：R743.3[医药卫生—神经病学与精神病学]