针刺联合补肾利咽方治疗肾虚血瘀型卒中后假性延髓麻痹的疗效及对患者吞咽功能和构音功能的影响  

Curative effect of acupuncture combined with Bushen Liyan Formula for post-stroke pseudobulbar palsy of kidney blood type and its effect on swallowing function and articulation function

作　　者：孙永胜[1] 漆慧 王非[1] SUN Yongsheng;QI Hui;WANG Fei(Department of Encephalopathy,Wuhan Hospital of Traditional Chinese Medicine,Wuhan,Hubei 430016;Wuhan Social Work Polytechnic,Wuhan,Hubei 430079)

机构地区：[1]湖北省武汉市中医医院脑病科,湖北武汉430016 [2]武汉民政职业学院,湖北武汉430079

出　　处：《河北中医》2022年第12期1979-1983,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：武汉市卫生健康委员会医学科研项目(编号:WZ20C36)。

摘　　要：目的观察针刺联合补肾利咽方治疗肾虚血瘀型卒中后假性延髓麻痹的疗效及对患者吞咽功能和构音功能的影响。方法将86例肾虚血瘀型卒中后假性延髓麻痹患者按照随机数字表法分为2组,对照组43例予常规西药及吞咽功能训练治疗,治疗组43例在对照组治疗基础上加用针刺联合补肾利咽方治疗,2组均治疗4周。比较2组疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后洼田饮水试验分级变化;比较2组治疗前后Frenchay构音障碍法(Frenchay)评分、吞咽障碍患者生活质量量表(SWAL-QOL)评分、美国国立卫生研究院卒中量表(NIHSS)评分变化。结果治疗组总有效率86.05%(37/43),对照组总有效率69.76%(30/43),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),治疗后治疗组中医证候各项评分及总评分均低于对照组(P<0.05)。2组治疗后洼田饮水试验分级均较本组治疗前降低(P<0.05),治疗后治疗组洼田饮水试验分级均低于对照组(P<0.05)。2组治疗后Frenchay评分、SWAL-QOL评分均较本组治疗前升高(P<0.05),NIHSS评分较本组治疗前降低(P<0.05);治疗后治疗组Frenchay评分、SWAL-QOL评分均高于对照组(P<0.05),NIHSS评分低于对照组(P<0.05)。结论针刺联合补肾利咽方治疗卒中后假性延髓麻痹,能提高患者吞咽功能和构音功能,改善生活质量,促进神经功能恢复。Objective To observe the curative effect of acupuncture combined with Bushen Liyan Formula for post-stroke pseudobulbar palsy of kidney blood type and its effect on swallowing function and articulation function.Methods A total of 86 patients with post-stroke pseudobulbar palsy(kidney blood type)were randomly assigned into the treatment group and the control group,43 cases per group.All patients were managed by conventional Western medicine+swallowing function training,and those in the treatment group were additionally treated with acupuncture combined with Bushen Liyan Formula.A 4-week treatment was performed to compare traditional Chinese medicine(TCM)syndrome score,water swallowing test(WST)grade,Frenchay Dysarthria Assessment(FDA),the Swallowing Quality of Life(SWAL-QOL),National Institutes of Health Stroke Scale(NIHSS).The curative effect was assessed.Results The overall effective rate was higher in the treatment group compared with the control group(86.05%[37/43]vs 69.76%[30/43]),[P<0.05],respectively.After treatment,TCM symptom scores in the both groups were decreased(P<0.05),which were decreased in the treatment group compared with the control group(P<0.05);WST grade in the both groups was decreased(P<0.05),the reduction in the treatment group was more prevalent with respect to the control group(P<0.05);elevated FDA scores and SWAL-QOL scores,and reduced NIHSS scores in the both groups were found(all P<0.05),improvement of the above indexes in the treatment group were better than the control group(all P<0.05).Conclusion Acupuncture combined with BushenLiyan Decoction in the treatment of post-stroke pseudobulbar palsy can significantly improve patients’swallowing and articulation function,improve their quality of life,and promote the recovery of neurological function.

关 键 词：假性延髓麻痹 卒中 并发症 针刺疗法 中药疗法 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R245.31[医药卫生—临床医学] R289.6