柴苓汤结合传统吞咽及神经肌肉电刺激疗法治疗缺血性脑卒中后吞咽障碍的临床效果  

Clinical effect of Chailing Decoction combined with traditional swallowing and neuromuscular electrical stimulation in the treatment of dysphagia after ischemic stroke

作　　者：张旭[1] 张莎莎[2] 吕文良[3] ZHANG Xu;ZHANG Shasha;LYU Wenliang(Department of Neurology,Huzhou First People’s Hospital,Zhejiang Province,Huzhou313000,China;Department of Traditional Chinese Medicine,Huzhou First People’s Hospital,Zhejiang Province,Huzhou313000,China;Department of Hepatology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China)

机构地区：[1]浙江省湖州市第一人民医院神经内科,浙江湖州313000 [2]浙江省湖州市第一人民医院中医科,浙江湖州313000 [3]中国中医科学院广安门医院肝病科,北京100053

出　　处：《中国医药导报》2022年第4期124-127,共4页China Medical Herald

基　　金：浙江省教育厅一般科研项目(Y202043801)。

摘　　要：目的观察柴苓汤结合传统吞咽及神经肌肉电刺激疗法(NMES)治疗缺血性脑卒中后吞咽障碍的临床效果。方法选取2019年7月至2020年6月于浙江省湖州市第一人民医院治疗的100例缺血性脑卒中后吞咽障碍患者,根据随机数字表法将其分成对照组和治疗组,各50例。对照组予以脑卒中常规药物,同时采用传统吞咽治疗和NMES修复吞咽功能;治疗组除上述治疗外,加用柴苓汤口服或鼻饲。两组均治疗4周,治疗前后均通过洼田饮水试验、美国国立卫生研究院卒中量表(NIHSS)及电视透视吞咽功能检查(VFSS)对比临床疗效。结果治疗组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组洼田饮水试验评分、NIHSS评分低于治疗前,VFSS评分高于治疗前,且治疗组洼田饮水试验评分、NIHSS评分低于对照组,VFSS评分高于对照组,差异有统计学意义(P<0.05)。结论柴苓汤结合传统吞咽疗法和NMES治疗缺血性脑卒中后吞咽障碍对患者吞咽功能的修复具有良好效果,值得临床推广。Objective To observe the clinical effect of Chailing Decoction combined with traditional swallowing and neuromuscular electrical stimulation(NMES)in the treatment of dysphagia after ischemic stroke.Methods One hundred patients with dysphagia after ischemic stroke treated in Huzhou First People’s Hospital from July 2019 to June 2020 were selected and divided into control group and treatment group according to random number table method,with 50 cases in each group.Control group was given routine drugs for stroke,and the swallowing function was repaired by traditional swallowing therapy and NMES.In addition to the above treatment,treatment group was treated with Chailing Decoction orally or nasal feeding.Both groups were treated for four weeks.Before and after treatment,the clinical effects were compared by water swallow test,National Institutes of Health stroke scale(NIHSS)and videofluoroscopic swallowing study(VFSS).Results The total clinical effective rate in treatment group was higher than that in control group(P<0.05).After treatment,the scores of water swallow test and NIHSS in two groups were lower than those before treatment,and VFSS scores in two groups were higher than those before treatment,the scores of water swallow test and NIHSS in treatment group were lower than those in control group,and the score of VFSS in treatment group was higher than that in control group,the differences were statistically significant(P<0.05).Conclusion Chailing Decoction combined with traditional swallowing and neuromuscular electrical stimulation has good effect in relieving dysphagia after ischemic stroke and it is worthy of clinical promotion.

关 键 词：缺血性脑卒中 吞咽功能障碍 柴苓汤 康复 

分 类 号：R277.7[医药卫生—中医学]