通督调神针刺联合项针治疗假性延髓麻痹的疗效观察  

Therapeutic Observation of Combining Tong Du Tiao Shen and Nape Acupuncture for Pseudobulbar Palsy

作　　者：黄兵[1] 宋曼萍 HUANG Bing;SONG Man-ping(Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院,海口570311

出　　处：《上海针灸杂志》2021年第11期1299-1304,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：海南省重点研发项目(SQ2019SHFZ0286)。

摘　　要：目的观察通督调神针刺联合项针治疗假性延髓麻痹的临床疗效。方法将195例假性延髓麻痹患者随机分为甲组(49例)、乙组(49例)、丙组(49例)与丁组(48例)。甲组给予西医常规治疗,乙组给予西医常规治疗联合项针治疗,丙组给予西医常规治疗联合通督调神法针刺,丁组给予西医常规治疗联合通督调神针刺及项针治疗。比较4组治疗前后吞咽功能、构音功能及语言功能变化情况,并比较临床疗效及不良事件发生情况。结果4组治疗后标准吞咽功能评估量表(SSA)评分均低于治疗前(P<0.05),乙组、丙组、丁组治疗后均低于甲组(P<0.05),丁组治疗后低于乙组、丙组(P<0.05),乙组和丙组比较差异无统计学意义(P>0.05)。4组治疗后Frenchay构音障碍评价量表评分及语言功能评分均高于治疗前(P<0.05),乙组、丙组、丁组治疗后均高于甲组(P<0.05),丁组治疗后高于乙组、丙组(P<0.05),乙组和丙组比较差异均无统计学意义(P>0.05)。丁组吞咽功能总有效率、构音功能总有效率、语言功能总有效率均高于甲组、乙组、丙组(P<0.01)。4组不良事件发生率比较差异无统计学意义(P>0.05)。结论在西医常规治疗基础上,通督调神法针刺联合项针治疗假性延髓麻痹患者,可明显促进其吞咽、语言及构音功能改善。Objective To observe the clinical efficacy of combining Tong Du Tiao Shen(unblocking the Governor Vessel and regulating the mind)and nape acupuncture in treating pseudobulbar palsy(PBP).Method A total of 195 PBP patients were randomized into group A(49 cases),group B(49 cases),group C(49 cases)and group D(48 cases).Group A was provided with conventional Western medicine treatment;group B was given conventional Western medicine treatment plus nape acupuncture;group C was intervened by conventional Western medicine treatment plus Tong Du Tiao Shen acupuncture;group D was offered conventional Western medicine treatment plus Tong Du Tiao Shen and nape acupuncture.Before and after treatment,the swallowing,articulation and language functions were compared among the four groups,as well as the clinical efficacy and incidence of adverse events.Result The standard swallowing assessment(SSA)score dropped after treatment in all the four groups(P<0.05),lower in groups B,C and D than in group A(P<0.05)and lower in group D than in groups B and C(P<0.05),while the difference between groups B and C was statistically insignificant(P>0.05).After treatment,the Frenchay dysarthria assessment(FDA)score and language function score increased in the four groups(P<0.05),higher in groups B,C and D than in group A(P<0.05)and higher in group D than in groups B and C(P<0.05),while the difference between groups B and C was statistically insignificant(P>0.05).The total effective rates,respectively based on the swallowing,articulation and language functions,were higher in group D than in groups A,B and C(P<0.01).There were no significant differences in the incidence of adverse events among the four groups(P>0.05).Conclusion Based on conventional Western medicine treatment,the additional use of Tong Du Tiao Shen and nape acupuncture can notably promote the improvement of swallowing,language and articulation functions in treating patients with PBP.

关 键 词：通督调神 针刺疗法 针药并用 项针 假性延髓麻痹 吞咽障碍 语言障碍 

分 类 号：R246.6[医药卫生—针灸推拿学]