清热通腑汤联合吞咽康复训练对急性缺血性脑卒中后真性球麻痹痰热腑实证患者吞咽功能康复的影响  

Effect of Qingre Tongfu Decoction Combined with Swallowing Rehabilitation Training on Swallowing Function Rehabilitation of Patients with Bulbar Paralysis after Acute Ischemic Stroke(Phlegm Heat and Fu-organ Syndrome)

作　　者：张超 潘平康 王晓玲 陈亮 ZHANG Chao;PAN Ping-kang;WANG Xiao-ling;CHEN Liang(Department of Encephalopathy,Ankang Hospital of Traditional Chinese Medicine,Ankang Shaanxi 725000)

机构地区：[1]安康市中医医院脑病科,陕西安康725000

出　　处：《世界中西医结合杂志》2022年第8期1644-1648,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：陕西省科学研究与技术开发计划项目(20192947)。

摘　　要：目的探讨清热通腑汤联合吞咽康复训练对急性缺血性脑卒中后真性球麻痹痰热腑实证患者吞咽功能康复的影响。方法选取2017年7月—2019年6月期间在安康市中医医院住院治疗的急性缺血性脑卒中后真性球麻痹患者110例,采用随机数字表法将患者随机分观察组和对照组,每组各55例。对照组在缺血性脑卒中的规范化治疗基础上给予吞咽康复训练治疗,观察组在对照组治疗基础上给予清热通腑汤治疗。治疗1个月后,观察两组患者治疗前后中医症状体征评分(舌强语謇、饮水发呛、痰多或咳痰、便秘便干、腹胀)、洼田饮水试验评分、标准吞咽功能评价量表(Standardized Swallowing Assessment,SSA)评分及吞咽X线荧光透视检查(Video Tluoroscopic Swallowing Study,VFSS)结果改善情况,记录两组患者不良反应情况,并对比两组患者治疗后临床疗效。结果治疗后观察组总有效率83.64%(46/55)明显高于对照组58.18%(32/55),差异有统计学意义(P<0.05)。两组患者治疗1个月后舌强语謇、饮水发呛、痰多或咳痰、便秘便干及腹胀评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组主要症状体征评分明显低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后洼田饮水试验评分、SSA量表评分均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组洼田饮水试验评分、SSA量表评分均明显低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后造影剂通过口腔时间和造影剂通过咽喉时间均较治疗前明显降低,VFSS评分均较治疗前明显升高,差异有统计学意义(P<0.01);且观察组造影剂通过口腔时间和造影剂通过咽喉时间明显低于对照组,VFSS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者均未出现明显的药物不良反应。结论自拟清热通腑汤联合吞咽康复训练对急性缺血性脑卒中后真性球�Objective To explore the effect of QingreTongfu Decoction combined with swallowing rehabilitation training on swallowing function rehabilitation of patients with bulbar paralysis after acute ischemic stroke(phlegm heat and fu-organ syndrome).Methods A total of 110 patients with bulbar paralysis after acute ischemic stroke treated in Ankang Hospital of Traditional Chinese Medicine from July 2017 to June 2019 were selected.The patients were randomly divided into a control group and an observation group by the random number table method,55 in each group.Patients in the control group were given swallowing rehabilitation training based on the standardized treatment of ischemic stroke,whilethose in the observation group were treated with QingreTongfu Decoction on the basis of the treatment of the control group.After 1 month of treatment,the scores of traditional Chinese medicine(TCM)symptoms and signs(stiff tongue with dysphasia,coughing in drinking water,excessive sputum or expectoration,constipation and dry stool,abdominal distension),Watian drinking water test,standard swallowing function evaluation scale(SSA)and swallowing X-ray fluoroscopy(VFSS)of the two groups of patients were observed before and after treatment,and the adverse reactions were recorded.The total effective rate of the two groups of patients was compared after treatment.Results The total effective rate of the observation group was 83.64%(46/55),significantly higher than 58.18%(32/55)of the control group(P<0.05).After 1 month of treatment,the scores of stiff tongue with dysphasia,coughing in drinking water,excessive sputum or expectoration,constipation and dry stool,abdominal distension,Watian drinking water test score,SSA score,and the time of contrast medium passing through the mouth and throat were decreased while the VFSS score was increased in the two groups compared with those before treatment(P<0.05 or P<0.01),and the observation group had more obvious decrease or increase than the control group(P<0.05).There were no significant drug-related

关 键 词：急性缺血性脑卒中 真性球麻痹 痰热腑实证 清热通腑汤 吞咽康复训练 洼田饮水试验 吞咽X线荧光透视检查 

分 类 号：R743[医药卫生—神经病学与精神病学]