吞咽分期深刺法治疗脑卒中后吞咽障碍  

Therapeutic Effect of Deep Acupuncture with Swallow Staging on Dysphagia After Stroke

作　　者：霍绮雯[1] 黄燕冰 林东雄[1] 金培群 HUO Qiwen;HUANG Yanbing;LIN Dongxiong;JIN Peiqun(Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong China 528000)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《中医学报》2020年第2期420-424,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81072947);佛山市卫生健康局医学科研课题(20200189);国家中医药管理局谭峰全国名老中医药专家传承工作室建设项目{国中医药人教发[2016]42号}。

摘　　要：目的:观察吞咽分期深刺法治疗脑卒中后吞咽障碍患者的临床疗效。方法:根据随机数字表将符合标准的脑卒中后吞咽障碍患者60例,分为治疗组与对照组,各30例,两组口腔期及咽期均各为15例。治疗组采用吞咽分期深刺法;对照组采用传统针刺法。治疗后,采用洼田饮水试验及藤岛一郎吞咽疗效评价标准对比两组疗效,并记录两组的不良事件。结果:两组患者治疗后洼田饮水试验评分较治疗前均显著下降(P<0.05),两组比较,治疗组优于对照组(P<0.05)。两组患者吞咽疗效比较,治疗组为94%(29/30),高于对照组的67%(20/30)(P<0.05)。两组口腔期患者治疗后洼田饮水试验评分较治疗前明显下降(P<0.05),且治疗组下降程度明显优于对照组(P<0.05);两组口腔期患者吞咽疗效比较,治疗组疗效为93%(14/15),对照组为60%(9/15),治疗组优于对照组(P<0.05)。两组咽期患者治疗后洼田饮水试验评分较治疗前显著下降(均P<0.05),且治疗组明显优于对照组(P<0.05);两组咽期患者吞咽疗效比较,治疗组为93%(14/15),对照组为73%(11/15),治疗组明显优于对照组(P<0.05)。两组不良反应发生较少,经处理后均好转。结论:吞咽分期深刺法治疗脑卒中后吞咽障碍是遵循辨证施治、中病即止的施针方法和治疗原则,疗效明显。Objective:To observe the clinical effect of deep-acupuncture with swallow staging on patients with dysphagia after stroke.Methods:According to the random number table,a total of 60 patients with dysphagia after stroke were divided into the treatment group and the control group,each with 30 patients.The oral and pharyngeal phases were both 15 in the two groups.The treatment group used the deep stinging method of swallowing stage;the control group used the traditional acupuncture method.After treatment,the efficacy of the two groups was compared using the Watian drinking water test and Fujishima Ichiro’s swallowing effect evaluation criteria,and adverse events of both groups were recorded.Results:The scores of the Watian drinking water test scores of the two groups after treatment were lower than those before treatment(P<0.05).Compared with the two groups,the treatment group was better than the control group(P<0.05).Comparison of swallowing efficacy between the two groups of patients,the treatment group was 94%,higher than the control group 67%(P<0.05).The scores of the Watian drinking water test in the two groups of oral patients after treatment were significantly lower than those before treatment(P<0.05),and the degree of decline in the treatment group was significantly better than that of the control group(P<0.05);The curative effect of the treatment group was 93%and that of the control group was 60%.The curative effect of the treatment group was higher than that of the control group(P<0.05).After treatment in the two groups of patients in the pharyngeal stage,the scores of the Watian drinking water test were lower than before treatment(both P<0.05),and the treatment group was significantly better than the control group(P<0.05).The control group was 73%,the treatment group was more effective than the control group(P<0.05).Adverse reactions occurred less frequently in both groups,and both improved after treatment.Conclusion:The deep-acupuncture method of swallowing in stages for the treatment of post-stroke dys

关 键 词：脑卒中 吞咽障碍 吞咽分期 深刺法 针刺疗法 

分 类 号：R255.2[医药卫生—中医内科学]