吞咽分期深刺法联合舌针治疗卒中后吞咽障碍的疗效及对脑血流量的影响  

Effect of Deep Needling by Swallowing Stage Combined with Tongue Acupuncture on Post-Stroke Dysphagia and Its Influence to Cerebral Blood Flow

作　　者：罗艳 徐双景 丁渊 胡宝 高福秋 徐兰平 王彤 LUO Yan;XU Shuangjing;DING Yuan;HU Bao;GAO Fuqiu;XU Lanping;WANG Tong(Kunshan Rehabilitation Hospital, Kunshan 215300, China)

机构地区：[1]昆山市康复医院,江苏昆山215300

出　　处：《针灸临床杂志》2022年第3期34-38,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：昆山市社会发展科技项目,编号:KS1770。

摘　　要：目的:探讨卒中后吞咽障碍采用吞咽分期深刺法联合舌针治疗的疗效。方法:随机将本院收治的脑卒中后吞咽障碍患者60例分为对照组(30例,舌针疗法)和治疗组(30例,吞咽分期深刺法联合舌针),对比治疗后临床疗效、VFSS评分、SWAL-QOL评分和洼田咽水试验评分、右侧椎动脉和左侧椎动脉的Vs、Vm和PI值及血清BDNF、NSE水平。结果:治疗后治疗组疗效较对照组明显提高,差异具有统计学意义(P<0.05);两组治疗前VFSS评分、SWAL-QOL评分和洼田咽水试验评分差异无统计学意义(P>0.05);治疗后两组洼田咽水试验评分较治疗前显著降低,VFSS评分和SWAL-QOL评分较治疗前显著升高,差异具有统计学意义(P<0.05);且治疗组VFSS评分、SWAL-QOL评分和洼田咽水试验评分较对照组改善较明显,差异具有统计学意义(P<0.05);两组治疗前右侧椎动脉和左侧椎动脉的Vs、Vm和PI值差异无统计学意义(P>0.05);两组治疗后右侧椎动脉和左侧椎动脉的Vs和Vm值较治疗前明显升高,PI值较治疗前明显降低,差异具有统计学意义(P<0.05);且治疗组右侧椎动脉和左侧椎动脉的Vs、Vm和PI值较对照组改善较明显,差异具有统计学意义(P<0.05);两组治疗前血清BDNF和NSE水平差异无统计学意义(P>0.05);两组治疗后血清BDNF水平较治疗前显著升高,血清NSE水平较治疗前显著降低,差异具有统计学意义(P<0.05);且治疗组血清BDNF和NSE水平较对照组改善较明显,差异具有统计学意义(P<0.05)。结论:卒中后吞咽障碍采用吞咽分期深刺法联合舌针治疗具有较好的效果。Objective:To investigate the effect of deep needling by swallowing stage combined with tongue acupuncture in the treatment of post-stroke dysphagia.Methods:60 patients with post-stroke dysphagia were randomly divided into the control group(n=30)and the treatment group(n=30).The control group was treated with tongue acupuncture;on which basis,the treatment group was also treated with deep needling by swallowing stage.Clinical efficacy was compared between the two groups.The scores of VFSS,SWAL-QOL and Kubato water drinking test,the values of Vs,Vm and PI of right and left vertebral artery,as well as the serum levels of BDNF and NSE were compared between before and after the treatment in the two groups.Results:After the treatment,the curative effect of the treatment group was significantly higher than that of the control group(P<0.05).There were no differences in the scores of VFSS,SWAL-QOL and Kubato water drinking test between the two groups before the treatment(P>0.05).The scores of Kubato water drinking test were significantly decreased,and the scores of VFSS and SWAL-QOL were significantly increased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the improvements were more significant in the treatment group(P<0.05).There were no statistical differences in the values of Vs,Vm and PI of right and left vertebral artery between the two groups before the treatment(P>0.05).The values of Vs and Vm of right and left vertebral artery were significantly increased,whereas the value of PI was significantly decreased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the changes were more significant in the treatment group(P<0.05).There was no statistical differences in the serum levels of BDNF and NSE between the two groups before the treatment(P>0.05).The serum level of BDNF was significantly increased,and the serum level of NSE was significantly decreased after the treatment compared to those before the treatment in the two groups(P

关 键 词：吞咽分期深刺法 舌针疗法 卒中 吞咽障碍 脑血流量 

分 类 号：R246.6[医药卫生—针灸推拿学]