项丛刺疗法治疗脑卒中后吞咽功能障碍的临床效果  

Clinical effect of nape cluster acupuncture in the treatment of swallowing dysfunction after stroke

作　　者：姚珊 郭鹏飞[1] 许德慧 孙洁[1] YAO Shan;GUO Pengfei;XU Dehui;SUN Jie(Department of Rehabilitation,Xuzhou Central Hospital,Jiangsu Province,Xuzhou 221009,China;the Second Clinical Medical School,Xuzhou Medical University,Jiangsu Province,Xuzhou 221004,China)

机构地区：[1]徐州市中心医院康复科,江苏徐州221009 [2]徐州医科大学第二临床学院,江苏徐州221004

出　　处：《中国医药导报》2022年第25期119-123,共5页China Medical Herald

基　　金：江苏省科技项目(BE2020638);徐州市医学领军人才培养项目(XWRCHT20210024)。

摘　　要：目的探讨项丛刺疗法治疗脑卒中后吞咽功能障碍的临床效果。方法选取2019年9月至2021年9月于徐州市中心医院收治的124例脑卒中后吞咽功能障碍患者,按照随机数字表法将其分为对照组和观察组,每组62例。对照组采用常规康复治疗,观察组在对照组的基础上,采用项丛刺疗法治疗。两组均以4周为1个疗程,持续治疗3个疗程。比较两组的临床疗效、吞咽功能评分、脑部血流动力学指标、脑损伤标志物水平及不良反应情况。结果观察组的临床疗效优于对照组(P<0.05)。治疗后两组洼田饮水试验、电视荧光吞咽造影检查、进食评估问卷调查工具量表-10评分均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后两组最大峰值流速(MPV)、平均流速(VM)均较治疗前增快,血管阻力指数(RI)较治疗前降低,且观察组MPV、VM均快于对照组,RI低于对照组(P<0.05)。治疗后两组血清淀粉样蛋白A、髓鞘碱性蛋白、磷脂转移蛋白因子水平均较治疗前降低,且观察组低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论项丛刺疗法治疗脑卒中后吞咽功能障碍的效果显著,可改善患者的吞咽功能、脑部血流微循环状态,降低脑损伤标志物水平,安全性较好。Objective To explore the clinical effect of nape cluster acupuncture in the treatment of swallowing dysfunction after stroke.Methods One hundred and twenty-four patients with swallowing dysfunction after stroke treated in Xuzhou Central Hospital from September 2019 to September 2021 were selected,and they were divided into control group and observation group by random number table method,with 62 cases in each group.The control group was treated with routine rehabilitation treatment,and the observation group was treated with nape cluster acupuncture on the basis of the control group.Both groups took four weeks as a course of treatment and continued for three courses of treatment.The clinical efficacy,swallowing function score,brain hemodynamic indexes,brain injury markers level and adverse reactions were compared between the two groups.Results The clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the scores of Kubota water swallowing test,video fluoroscopic swallowing study and eating assessment tool-10 score in the two groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,maximum peak velocity(MPV)and average velocity(VM)in the two groups were faster than those before treatment,resistance index(RI)in the two groups was lower than before treatment,and MPV and VM in the observation group were faster than those in the control group,RI in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of serum amyloid A,myelin basic protein and phospholipid transfer protein factor in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Nape cluster acupuncture is effective in the treatment of swallowing dysfunction aft

关 键 词：脑卒中 吞咽功能障碍 项丛刺疗法 临床疗效 脑损伤标志物 

分 类 号：R277.7[医药卫生—中医学]