利咽开窍针法联合吞咽-摄食康复训练与常规疗法治疗脑卒中后吞咽障碍临床研究  

Clinical Study on Liyan Kaiqiao Needling Method Combined with Swallowing-Feeding Rehabilitation Training and Routine Therapy for Dysphagia After Stroke

作　　者：姚文娟 陈棋 YAO Wenjuan;CHEN Qi

机构地区：[1]浙江中医药大学研究生院,浙江杭州310053 [2]诸暨市中医医院康复医学科,浙江诸暨311800

出　　处：《新中医》2022年第16期156-161,共6页New Chinese Medicine

摘　　要：目的:观察在常规疗法与吞咽-摄食康复训练基础上加用利咽开窍针法治疗脑卒中后吞咽障碍的疗效。方法:选取124例脑卒中后吞咽障碍患者,随机分为对照组64例和治疗组60例,2组患者入院后均予抗血小板、保护神经等常规治疗,在康复训练师的指导下进行吞咽-摄食康复训练,治疗组加予利咽开窍针法治疗,2组均治疗4周。治疗前后评定患者的洼田饮水试验评分、标准吞咽功能评价量表(SSA)评分和电视透视吞咽功能检查(VFSS)评分、中医证候评分,检测血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平。比较2组治疗后的临床疗效。结果:治疗后,对照组临床疗效总有效率79.69%,治疗组总有效率96.67%,2组比较,差异有统计学意义(P<0.01)。2组洼田饮水试验评分、SSA评分均较治疗前降低,VFSS评分均较治疗前升高,差异均有统计学意义(P<0.05);治疗组洼田饮水试验评分、SSA评分均低于对照组,VFSS评分高于对照组,差异均有统计学意义(P<0.05)。2组语言不利、半身不遂、口角流涎、口眼歪斜评分均较治疗前降低,差异均有统计学意义(P<0.05);治疗组4项评分均低于对照组,差异均有统计学意义(P<0.05)。2组血清BDNF、NGF水平均较治疗前升高,差异均有统计学意义(P<0.05);治疗组血清BDNF、NGF水平均高于对照组,差异均有统计学意义(P<0.05)。结论:在常规疗法与吞咽-摄食康复训练基础上加用利咽开窍针法治疗脑卒中后吞咽障碍可提高疗效,不仅能够改善吞咽障碍,还能够促进脑卒中病情康复。Objective:To observe the curative effect of the additional application of Liyan Kaiqiao needling method based on routine therapy and swallowing-feeding rehabilitation training for dysphagia after stroke.Methods:A total of 124 cases of patients with dysphagia after stroke were selected and randomly divided into the control group and the treatment group,with 64 and 60 cases in each group respectively.After admission,both groups were given routine treatment including antiplatelet and nerve protection,as well as swallowing-feeding rehabilitation training under the guidance of rehabilitation trainer;the treatment group was additionally treated with Liyan Kaiqiao needling method.Both groups were treated for four weeks.Before and after treatment,the scores of water swallow test,standardized swallowing assessment(SSA),videofluoroscopic swallow study(VFSS) and Chinese medicine syndromes in the two groups were evaluated,and the levels of brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) were detected.After treatment,the clinical effects in the two groups were compared.Results:After treatment,the total effective rate was 79.69% in the control group and 96.67% in the treatment group,the difference being significant(P<0.01).The scores of water swallow test and SSA in the two groups were decreased when compared with those before treatment,and the VFSS scores were increased,differences being significant(P<0.05);the scores of water swallow test and SSA in the treatment group were lower than those in the control group,and the VFSS score was higher than that in the control group,differences being significant(P<0.05).The scores of unsmooth speech,hemiplegia,angular salivation and deviation of the eye and mouth in the two groups were decreased when compared with those before treatment,differences being significant(P<0.05);the above four scores in the treatment group were lower than those in the control group,differences being significant(P<0.05).The levels of BDNF and NGF in serum in the two groups were increased

关 键 词：脑卒中 吞咽障碍 利咽开窍针法 吞咽-摄食康复训练 吞咽功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R245.3[医药卫生—临床医学]