赖氏通元针法治疗缺血性脑卒中吞咽功能障碍的临床观察  

Clinical Observation of LAI’s Tongyuan Acupuncture Therapy in the Treatment of Dysphagia in Ischemic Stroke

作　　者：李季 代明星 谭荐文 张益丽 周罗林 谭兴举 罗玳红 张瑾[3,5] LI Ji;DAI Ming-Xing;TAN Jian-Wen;ZHANG Yi-Li;ZHOU Luo-Lin;TAN Xing-Ju;LUO Dai-Hong;ZHANG Jin(Mianyang Central Hospital/Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology,Mianyang 621000 Sichuan,China;Chongqing Zhennan Institute of Traditional Chinese Medicine,Chongqing 402160,China;Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang),Shenzhen 518122 Guangdong,China;The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630 Guangdong,China)

机构地区：[1]绵阳市中心医院/电子科技大学医学院附属绵阳医院,四川绵阳621000 [2]重庆桢楠中药研究所,重庆402160 [3]广州中医药大学,广东广州510006 [4]北京中医药大学深圳医院(龙岗),广东深圳518122 [5]中山大学附属第三医院,广东广州510630

出　　处：《广州中医药大学学报》2022年第10期2296-2302,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药管理局资助项目(编号:20182133);全国名老中医药专家赖新生传承工作室建设项目(编号:国中医药人教发201420)。

摘　　要：【目的】观察赖氏通元针法治疗缺血性脑卒中吞咽功能障碍的临床疗效。【方法】将160例缺血性脑卒中吞咽功能障碍患者随机分为观察组和对照组,每组各80例。对照组给予吞咽功能训练治疗,观察组在对照组治疗的基础上给予赖氏通元针法治疗,2组患者均治疗30 d。治疗30 d后,评价2组临床疗效,观察2组患者治疗前后中医证候积分、吞咽障碍生活质量量表(EDQoL)评分的变化情况,以及洼田饮水试验、Rosenbek误吸程度的情况。比较2组患者治疗前后血液流变学指标的变化情况,并评价2组患者治疗后进食水的情况。【结果】(1)观察组总有效率为82.50%(66/80),对照组为67.50%(54/80)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的中医证候积分明显改善(P<0.05),且观察组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,观察组洼田饮水试验疗效与Rosenbek误吸程度疗效评价均明显优于对照组,差异均有统计学意义(P<0.05)。(4)观察组患者可进水、可进食流质物、可进食糊状物、可进食固体食物情况均优于对照组,差异均有统计学意义(P<0.05)。(5)治疗后,2组患者的EDQoL量表各维度评分及总分均明显改善(P<0.05),且观察组在改善EDQoL量表各维度评分及总分方面明显优于对照组,差异均有统计学意义(P<0.05)。(6)治疗后,2组患者的全血黏度、血浆黏度、纤维蛋白原水平均明显改善(P<0.05),且观察组在改善全血黏度、血浆黏度、纤维蛋白原水平方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】赖氏通元针法治疗缺血性脑卒中吞咽功能障碍,能有效减轻患者的临床症状,改善患者的血液流变学指标,提高患者的生活质量,临床疗效显著。Objective To observe the clinical efficacy of LAI’s Tongyuan Acupuncture Therapy(an acupuncture therapy for dreging the governer vessel to negulate mind and conducting qi back to its source)in treating patients with dysphagia in ischemic stroke.Methods A total of 160 patients with dysphagia in ischemic stroke were randomly divided into the observation group and the control group,with 80 patients in each group.The control group was treated with swallowing function training,while the observation group was treated with LAI’s Tongyuan Acupuncture Therapy on the basis of the treatment in the control group.Both groups of patients were treated for30 days.After 30 days of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the traditional Chinese medicine(TCM)syndrome score and the eating disorders quality of life(EDQoL)score,as well as the evaluation of water swallow test and the Rosenbek aspiration degree were observed in the two groups before and after treatment.The changes of blood hemorheological indexes were compared in the two groups before and after treatment,and the water intake of the two groups after treatment was evaluated.Results(1)The total effective rate of the observation group was 82.50%(66/80)and that of the control group was 67.50%(54/80).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the TCM syndrome scores,the difference being statistically significant(P<0.05).(3)After treatment,the efficacy of the water swallow test and the efficacy evaluation of the Rosenbek aspiration degree in the observation group were both significantly superior to those in the control group,and the differences were both statistically significant(P<0.05).(4)Status of patients in the observation group were superior to the con

关 键 词：赖氏通元针法 缺血性脑卒中 吞咽功能障碍 血液流变学 

分 类 号：R246.9[医药卫生—针灸推拿学]