舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难临床疗效观察  

Clinical Effect of Scattered Needling at Tongue Surface Combined with Pricking at Jinjin and Yuye in Treatment of Post-stroke Dysphagia

作　　者：宋苗苗[1] 王颖[1] SONG Miao-miao;WANG Ying(The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《安徽中医药大学学报》2022年第4期60-64,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽省第十三批“115”产业创新团队(皖人才办[2020]4号);安徽省中医药传承创新科研项目(2020cczd04)。

摘　　要：目的探讨舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难的临床疗效。方法将60例脑卒中后吞咽困难患者,采用随机数字表法按患者入院先后顺序随机分为对照组30例,治疗组30例。两组均给予神经内科常规西药治疗及吞咽功能康复训练,对照组采用常规针刺,取廉泉、风府、哑门穴,治疗组在对照组基础上采用舌面散刺联合金津、玉液点刺出血,2周为1个疗程。2周后采用洼田饮水试验量表、改良曼恩吞咽能力评估(Mann assessment of swallowing ability,MASA)量表、改良Barthel指数(modified Barthel index,MBI)量表评价并比较两组的疗效。结果治疗后两组患者洼田饮水试验量表评级比较,差异有统计学意义(Z=-4.026,P=0.000);且治疗后治疗组的洼田饮水试验量表评级在Ⅰ级、Ⅱ级分布占比较多;广义估计方程统计结果表明,两组治疗方法产生的疗效不同,治疗组吞咽功能恢复情况优于对照组(P<0.05),治疗后吞咽功能疗效优于治疗前(P<0.05)。两组患者治疗后MBI量表评分、MASA评分均较治疗前显著升高(P<0.05),且治疗组MBI量表评分升高程度大于对照组(P<0.05)。结论舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难疗效确切,该治疗方法可促进神经功能恢复,减轻患者脑卒中后吞咽困难症状,提高患者生活质量。Objective To investigate the clinical effect of scattered needling at tongue surface combined with pricking at Jinjin and Yuye in the treatment of post-stroke dysphagia.Methods A total of 60patients with post-stroke dysphagia were randomly divided into control group and treatment group according to the order of admission using a random number table,with 30patients in each group.Both groups were given conventional Western medicine treatment in neurology and swallowing function rehabilitation training;besides,the patients in the control group were given conventional acupuncture at Lianquan,Fengfu,and Yamen acupoints,and those in the treatment group were given scattered needling at tongue surface combined with pricking at Jinjin and Yuye in addition to the treatment in the control group;each course of treatment was 2weeks.After 2weeks of treatment,water swallow test,modified Mann Assessment of Swallowing Ability(MASA)scale,and modified Barthel Index(MBI)were used for evaluation,and treatment outcome was compared between the two groups.Results After treatment,there was a significant difference in the grade of dysphagia based on water swallow test between the two groups(Z =-4.026,P=0.000),and compared with the control group,the treatment group had a higher proportion of patients with gradeⅠ orⅡ dysphagia.Statistical results based on generalized estimating equation showed that the treatment methods in the two groups achieved different treatment outcomes,and the treatment group had significantly better recovery of swallowing function than the control group(P<0.05)and a significant improvement in the treatment outcome of swallowing function after treatment(P<0.05).Both groups had significant increases in MBI and MASA scores after treatment(P<0.05),and the treatment group had a significantly greater increase in MBI score compared with the control group(P<0.05).Conclusion Scattered needling at tongue surface combined with pricking at Jinjin and Yuye has a marked clinical effect in the treatment of post-stroke dysphagia

关 键 词：舌面散刺 金津 玉液 点刺出血 脑卒中 吞咽困难 

分 类 号：R743.3[医药卫生—神经病学与精神病学]