恢刺廉泉穴治疗脑卒中后吞咽障碍:随机对照试验  

Lateral needling at Lianquan(CV 23)for post-stroke dysphagia:a randomized controlled trial

作　　者：梁雪松 阎路达 张瑜 单筱淳 刘佩东 周鹏[2] LIANG Xue-song;YAN Lu-da;ZHANG Yu;SHAN Xiao-chun;LIU Pei-dong;ZHOU Peng(Department of Acupuncture and Moxibustion Second Affiliated Hospital of Guangzhou University of CM,Guangzhou 510120,Guangdong Province,China;Department of Acupuncture and Moxibustion,Shenzhen Baoan TCM Hospital Group,Shenzhen 518100,Guangdong Province)

机构地区：[1]广州中医药大学第二附属医院针灸科,广东广州510120 [2]深圳市宝安区中医院针灸科,广东深圳518100

出　　处：《中国针灸》2022年第7期717-720,共4页Chinese Acupuncture & Moxibustion

基　　金：广东省深圳市宝安区科技创新局医疗卫生基础研究项目:2020JD483。

摘　　要：目的:观察恢刺廉泉穴对脑卒中后吞咽障碍的影响,探讨其作用机制。方法:将64例脑卒中后吞咽障碍患者随机分为观察组和对照组,每组32例。两组均给予常规基础治疗,观察组穴取廉泉,采用恢刺手法不留针,每日1次;对照组采用吞咽康复训练治疗,每日1次。两组均每周治疗5 d,休息2 d,1周为一疗程,共4个疗程。比较两组患者治疗前后洼田饮水试验分级、标准吞咽功能评价量表(SSA)评分,采用视频吞咽造影检查(VFSS)测量观察组患者治疗前后舌骨运动位移、咽期运送时间。结果:治疗后,两组患者洼田饮水试验分级均较治疗前改善(P<0.05),且观察组优于对照组(P<0.05);两组患者SSA评分均较治疗前降低(P<0.05),观察组低于对照组(P<0.05)。与治疗前比较,观察组患者治疗后舌骨运动位移增加、咽期运送时间缩短(P<0.05)。结论:恢刺廉泉穴可改善脑卒中后吞咽障碍患者吞咽障碍症状,可能与增加舌骨运动位移、缩短咽期运送时间有关。Objective To observe the effect of lateral needling at Lianquan(CV 23)for post-stroke dysphagia,and explore its mechanism.Methods A total of 64 patients with post-stroke dysphagia were randomly divided into an observation group and a control group,32 cases in each group.Both groups were treated with conventional basic treatment.The observation group was treated with lateral needling at CV 23,without needle retaining,once a day.The control group was treated with swallowing rehabilitation training,once a day.Both groups were treated for 5 days a week,with 2 days interval,1 week as one course and 4 courses were required.Before and after treatment,the Kubota water swallowing test grade and standardized swallowing assessment(SSA)score were compared in the two groups.Before and after treatment,the video fluoroscopic swallowing study(VFSS)was used to measure the hyoid bone movement displacement and pharyngeal delivery time in the observation group.Results Compared before treatment,the Kubota water swallowing test grade after treatment was improved in the two groups(P<0.05),and the observation group was superior to the control group(P<0.05);the SSA scores after treatment were decreased in the two groups(P<0.05),and the observation group was lower than the control group(P<0.05).Compared before treatment,the hyoid bone movement displacement was increased and pharyngeal delivery time was shortened after treatment in the observation group(P<0.05).Conclusion Lateral needling at CV 23 could improve dysphagia symptoms in patients with post-stroke dysphagia,its mechanism may be related to the increasing of hyoid bone movement displacement and shortening of pharyngeal delivery time.

关 键 词：脑卒中后吞咽障碍 恢刺 穴 廉泉 洼田饮水试验 标准吞咽功能评价量表(SSA)评分 视频吞咽造影检查(VFSS) 

分 类 号：R246.1[医药卫生—针灸推拿学]