揿针联合嗓音训练治疗喉良性增生性病变随机对照试验  

Press Needle Combined with Voice Therapy Treating Benign Vocal Fold Lesions:A Randomized Controlled Trial

作　　者：梁方琪[1] 王连凤 田理[1] LIANG Fang-qi;WANG Lian-feng;TIAN Li(Department of Otolaryngology,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610075;College of Clinical Medicine,Chengdu University of Traditional Chinese Medicine,Chengdu,610075)

机构地区：[1]成都中医药大学附属医院耳鼻咽喉科,成都610075 [2]成都中医药大学临床医学院,成都610075

出　　处：《中国中西医结合杂志》2020年第6期685-690,共6页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察揿针联合嗓音训练治疗喉良性增生性病变的临床疗效。方法采用随机对照试验设计,选择2018年3月—2019年1月就诊于成都中医药大学附属医院耳鼻咽科门诊的喉良性增生性患者56例。按随机数字表分为试验组和对照组,每组28例。试验组采用揿针(贴埋于双侧人迎、列缺、照海穴)联合嗓音训练(1次/5日,40 min/次)进行治疗,对照组采用安慰针(规格与试验组一致,但无针尖,贴埋于双侧人迎、列缺、照海穴)联合嗓音训练(1次/5日,40 min/次)进行治疗。疗程为20日。患者于治疗前后填写嗓音活动与参与量表(VAPP),进行频闪喉镜检查及嗓音声学分析,比较治疗前后VAPP量表各项积分、声带黏膜波、声门闭合相、基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)、谐噪比(HNR)指标变化评估临床疗效。结果与本组治疗前比较,两组VAPP量表积分ALS值、PRS值、E值、V值,声带黏膜波、声门闭合相以及嗓音声学分析指标F0、jitter、shimmer、HNR结果均改善(P<0.01,P<0.05),且试验组治疗后改善优于对照组(P<0.01,P<0.05)。结论揿针联合嗓音训练治疗喉良性增生性疾病疗效优于安慰针联合嗓音训练治疗。Objective To evaluate the clinical efficacy of press needle combined with voice therapy in the treatment of benign vocal fold lesions.Methods A randomized controlled study was conducted,totally 56 patients with benign vocal fold lesions were enrolled in the Otolaryngological Clinic of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from March 2018 to January 2019.According to the random number table,the patients were randomly assigned to experimental group(28 cases)and control group(28 cases),the experimental group was treated with press needle(embedded in bilateral acupoints of Renying[ST 9],Lieque[LU 7]and Zhaohai[KI 6])combined with voice training(once every 5 days for 40 minutes each time),while the control group was treated with placebo acupuncture(with the specifications as the experimental group,but no needle tip,embedded in the bilateral acupoints of ST 9,LU 7 and KI 6)combined with voice training(once every 5 days for 40 minutes each time).The therapeutic course for all was 20 days.The voice activity and participation profile(VAPP)was filled in before and after treatment,electronic dynamic laryngoscopy examination and voice acoustic analysis was performed.the VAPP scores,mucosal wave of vocal fold,glottal closure feature,fundamental frequency(F0),frequency perturbation(jitter),amplitude perturbation(shimmer)and harmonic to noise ratio(HNR)were compared.Results Compared with before treatment,the integral ALS,PRS,E,V of VAPP,vocal cord mu-cosal wave,vocal cord closure,and F0,jitter,shimmer,HNR in voice acoustic analysis improved significantly(P<0.01,P<0.05),the improvement of experimental group was better than that of control group(P<0.01,P<0.05).Conclusion The effect of press needle combined with voice therapy for benign vocal fold lesions is greater than that of placebo acupuncture combined with voice therapy.

关 键 词：揿针 嗓音训练 喉良性增生性病变 随机对照研究 VAPP量表 

分 类 号：R246.81[医药卫生—针灸推拿学]