Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern  

针刺加康复训练治疗气虚血瘀型中风后吞咽障碍疗效评价

作　　者：Huang Yi-qing Ma Wen Shen Wei-dong 黄逸清;马文;沈卫东(Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Yangpu Hospital of Traditional Chinese Medicine,Shanghai 200090,China)

机构地区：[1]Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China [2]Shanghai Yangpu Hospital of Traditional Chinese Medicine,Shanghai 200090,China

出　　处：《Journal of Acupuncture and Tuina Science》2020年第5期367-373,共7页针灸推拿医学（英文版）

基　　金：上海市科学技术委员会科研计划项目,No.16401970402,No.18401970601;上海市卫生和计划生育委员会项目,No.ZY(2018-2020)-CCCX-1005;上海市卫生健康委员会科研课题计划项目,No.20204Y0470。

摘　　要：Objective:To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke deglutition disorders of qi-deficiency blood stasis pattern.Methods:Sixty-six patients with post-stroke deglutition disorders of qi-deficiency blood stasis patter were divided into an observation group and a rehabilitation group using the random number table method.The two groups both received conventional medications and supportive treatment for stroke.In addition,the observation group received acupuncture plus rehabilitation training while the rehabilitation group only received the same rehabilitation training.The interventions were conducted 3 times a week for a total of 4 weeks in both groups.They were evaluated using Kubota water swallowing test(KWST),Fujishima Ichiro food intake level scale(FILS)and symptoms score of traditional Chinese medicine(TCM)before and after treatment,and at the 1-month follow-up.The therapeutic efficacy was assessed at the 1-month follow-up.Results:The KWST grading and FILS result after treatment and at the follow-up were significantly different from those before treatment in both groups(all P<0.001);the results of these two items at the follow-up were not significantly different from those after treatment in the two groups(all P>0.05).There were significant differences in the KWST grading and FILS result between the two groups after treatment and at the follow-up(all P<0.05).The TCM symptoms score changed significantly after treatment and at the follow-up compared with that before treatment in both groups(all P<0.001).The TCM symptoms grading efficacy at the follow-up was significantly different from that after treatment in the observation group(P<0.05),while the difference was statistically insignificant in the rehabilitation group(P>0.05).The TCM symptoms grading efficacy in the observation group was significantly different from that in the rehabilitation group after treatment and at the follow-up(both P<0.05).Conclusion:Based on the conventional treatment for stroke,ac目的:观察针刺加康复训练治疗气虚血瘀型中风后吞咽障碍的临床疗效.方法:将66例气虚血瘀型中风后吞咽障碍患者按照随机数字表法分为观察组和康复组.两组均接受中风常规药物及支持治疗,在此基础上,观察组接受针刺加康复训练治疗,康复组接受与观察组相同的康复训练治疗.两组均每周治疗3次,共治疗4周.于治疗前、治疗后及治疗后1个月随访时进行洼田饮水试验、藤岛一郎吞咽困难分级量表及中医症状评分,于治疗后1个月随访时进行疗效评价.结果:两组治疗后及随访时的洼田饮水试验评级及藤岛一郎吞咽疗效评价结果均与本组治疗前有统计学差异(均P<0.001);两组随访时的上述两项评价结果与本组治疗后均无统计学差异(均P>0.05).治疗后及随访时观察组洼田饮水试验评级及藤岛一郎吞咽困难分级量表评价结果均与同时间点康复组评价结果有统计学差异(均P<0.05).两组治疗后及随访时的中医症状评分均与本组治疗前有统计学差异(均P<0.001);观察组随访时中医症状分级疗效与治疗后有统计学差异(P<0.05),而康复组随访时中医症状分级疗效与治疗后无统计学差异(P>0.05);治疗后及随访时观察组中医症状分级疗效均与同时间点康复组均有统计学差异(均P<0.05).结论:在中风常规治疗基础上,针刺加康复训练及单独康复训练均可改善气虚血瘀型中风后吞咽障碍临床症状,针刺加康复训练疗效更佳,且对于中医症状改善的远期疗效较好.

关 键 词：Acupuncture Therapy Stroke Rehabilitation Qi-deficiency Blood Stasis Poststroke Syndrome Pseudobulbar Palsy Deglutition Disorders 

分 类 号：R246.6[医药卫生—针灸推拿学]