基于纤维喉镜吞咽功能评估观察针刺对中风后吞咽障碍的影响  

Effect of acupuncture for dysphagia after stroke based on fiberoptic endoscopic swallowing function evaluation

作　　者：林茜 李秀宇 陈玲莉 陈美云 林淑芳 LIN Qian;LI Xiu-yu;CHEN Ling-li;CHEN Mei-yun;LIN Shu-fan(Rehabilitation Hospital of Fujian University of TCM,Department of Acupuncture and Moxibustion,Fuzhou 350003,China;Speech Therapy Department,Department of Acupuncture and Moxibustion,Fuzhou 350003,China;Outpatient Department,Department of Acupuncture and Moxibustion,Fuzhou 350003,China;Fujian Key Laboratory of Rehabilitation Technology,Fuzhou 350003)

机构地区：[1]福建中医药大学附属康复医院言语治疗部,福州350003 [2]福建省康复技术重点实验室,福州350003 [3]福建中医药大学附属康复医院门诊部,福州350003 [4]福建中医药大学附属康复医院针灸部,福州350003

出　　处：《中国针灸》2022年第5期486-490,共5页Chinese Acupuncture & Moxibustion

基　　金：福建省卫生健康委员会面向农村和城市社区推广适宜技术项目:2020TG019。

摘　　要：目的:在常规治疗和吞咽功能训练基础上,观察针刺对中风后吞咽障碍患者咽部运动、感觉功能及渗透-误吸情况的影响。方法:将60例中风后吞咽障碍患者随机分为观察组和对照组,每组30例。两组患者均给予常规治疗和吞咽功能训练,观察组在此基础上于廉泉、风府、翳风行针刺治疗。均每天1次,每周治疗5d,共治疗4周。于治疗前后应用纤维喉镜观察两组患者咽部运动功能、感觉功能及渗透-误吸情况,评定洼田饮水试验评分,并比较两组的临床疗效。结果:治疗后,两组患者咽部运动、感觉功能较治疗前提高(P<0.05),且观察组优于对照组(P<0.05);两组患者渗透-误吸评分、洼田饮水试验评分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组总有效率为93.3%(28/30),优于对照组的73.3%(22/30,P<0.05)。结论:在常规治疗和吞咽功能训练基础上,针刺可改善中风后吞咽障碍患者咽部运动功能、感觉功能及渗透-误吸情况。Objective To observe the effect of acupuncture combined with regular treatment and swallowing function training on pharyngeal motor, sensory function and penetration-aspiration function in patients with dysphagia after stroke.Methods A total of 60 patients with dysphagia after stroke were randomly divided into a control group and an observation group, 30 patients in each group. Both groups were treated with conventional treatment and swallowing function training;in addition, the observation group was treated with acupuncture at Lianquan(CV 23), Fengfu(GV 16), Yifeng(TE 17). All the treatments were given once a day, 5 days a week, for totally 4 weeks. In the two groups, the pharyngeal motor and sensory function, penetration-aspiration scores were evaluated by fiberoptic endoscopic evaluation of swallowing(FEES), and the Kubota water swallowing test scores were assessed before and after treatment, and the clinical effects were compared. Results After treatment, the pharyngeal motor and sensory function in the two groups were all higher than those before treatment(P<0.05), and those in the observation group were better than the control group(P < 0.05). After treatment, the penetration-aspiration scores and Kubota water swallowing test scores in the two groups were all lower than those before treatment(P<0.05), and those in the observation group were lower than the control group(P<0.05). The total effective rate was 93.3%(28/30) in the observation group, which was better than 73.3%(22/30) in the control group(P<0.05). Conclusion Acupuncture combined with regular treatment and swallowing training could improve the pharyngeal motor and sensory function, and penetration-aspiration scores in patients with dysphagia after stroke.

关 键 词：中风后吞咽障碍 针刺 纤维喉镜 吞咽功能评估 洼田饮水试验 

分 类 号：R246.6[医药卫生—针灸推拿学]