调神利咽针刺联合咽部冷刺激治疗急性脑梗死后吞咽障碍临床研究  

Clinical Study on Tiaoshen Liyan Acupuncture Combined with Cold Pharyngeal Stimulation in Treating Dysphagia after Acute Cerebral Infarction

作　　者：宋巍 王晓强 杨娜 SONG Wei;WANG Xiaoqiang;YANG Na(Rehabilitation Physiotherapy Department of People's Hospital of Beijing Daxing District,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院康复理疗科,北京大兴102600

出　　处：《山东中医药大学学报》2020年第6期663-667,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：北京市科技计划-首都特色项目(编号:ZZ181100004216188)。

摘　　要：目的:观察调神利咽针刺联合咽部冷刺激对急性脑梗死后吞咽障碍患者吞咽功能、营养状况及神经功能的影响,为临床治疗提供借鉴。方法:收集2018年1月至2019年1月收治的急性脑梗死后发生吞咽障碍的患者86例,通过随机数字表法将其分为治疗组和对照组各43例,两组均予常规西医治疗,病情稳定无进展后于入院第3天行咽部冷刺激治疗,在此基础上治疗组联合调神利咽针刺治疗,疗程均为3周。治疗前后,分别测定两组患者吞咽功能、微型营养评价(mini nutritional assessment,MNA)评分及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分,并据以判定吞咽障碍疗效、营养状况及神经功能变化。结果:治疗3周后,治疗组和对照组吞咽功能改善总有效率分别为90.70%、76.74%,差异有统计学意义(P<0.05);治疗3周后,两组MNA评分均较治疗前升高(P<0.05),且治疗组高于对照组(P<0.05),两组营养状况良好率均较治疗前升高、营养不良危险率均较治疗前降低(P<0.05),且治疗组效果优于对照组(P<0.05);治疗3周后,两组NIHSS评分均较治疗前明显降低(P<0.05),且治疗组低于对照组(P<0.05)。结论:调神利咽针刺联合咽部冷刺激可以有效改善急性脑梗死后吞咽障碍患者吞咽功能、营养状况,同时提升其神经功能,值得临床借鉴。Objective:To investigate the effects of Tiaoshen Liyan acupuncture combined with cold pharyngeal stimulation on swallowing function,nutritional condition and neurological function in patients with dysphagia after acute cerebral infarction.Methods:Total 86 patients with dysphagia after acute cerebral infarction admitted from January 2018 to January 2019 were selected and divided into the treatment group and control group by random number method,with 43 patients in each group.Both groups received conventional western medicine treatment.After their condition was stable without progress,they were treated with cold pharyngeal stimulation on the 3rd day after admission.On this basis,the treatment group was treated with Tiaoshen Liyan acupuncture,and the course of treatment was 3 weeks.Before and after treatment,the swallowing function,mini nutritional assessment(MNA)score and National Institute of Health stroke scale(NIHSS)score of the patients in the two groups were measured respectively to determine the efficacy of dysphagia,nutritional status and neurological function changes.Results:After 3 weeks of treatment,the effective rates of swallowing function improvement in the treatment group and the control group were 90.70%and 76.74%,respectively,with statistically significant differences(P<0.05).After 3 weeks of treatment,MNA scores in both groups were higher than those before treatment(P<0.05),and MNA score in the treatment group was higher than that in the control group(P<0.05).The rate of good nutritional status in both groups was higher than that before treatment,and the risk of malnutrition was lower than that before treatment(P<0.05),and the effect of the treatment group was better than that of the control group(P<0.05).After 3 weeks of treatment,NIHSS score in both groups was significantly lower than that before treatment(P<0.05),and NIHSS score in the treatment group was lower than that in the control group(P<0.05).Conclusions:Combined with cold pharyngeal stimulation,Tiaoshen Liyan acupuncture can effectively

关 键 词：调神利咽针刺 咽部冷刺激 急性脑梗死 吞咽障碍 微型营养评价评分 美国国立卫生研究院卒中量表评分 

分 类 号：R245[医药卫生—针灸推拿学] R246.6[医药卫生—中医临床基础]