耳穴磁疗联合常规疗法治疗神经性吞咽障碍临床研究  

Clinical Study on Auricular Point Magnetic Therapy Combined with Routine Therapy for Neurogenic Dysphagia

作　　者：陈妙 周荣[1] 朱文宗[1] 陈茹 黄祖秀 林书阳 CHEN Miao;ZHOU Rong;ZHU Wenzong;CHEN Ru;HUANG Zuxiu;LIN Shuyang

机构地区：[1]温州市中医院神经内科,浙江温州325000 [2]瑞安市食品检验检测中心,浙江瑞安325200

出　　处：《新中医》2023年第8期185-189,共5页New Chinese Medicine

基　　金：浙江省中医药科学研究基金计划B类项目(2020ZB239);温州市科技计划项目(Y20190044)。

摘　　要：目的:观察耳穴磁疗联合常规疗法治疗神经性吞咽障碍的临床疗效。方法:选择90例神经性吞咽障碍患者,按照随机数字表法分为对照组和观察组各45例,2组患者均接受营养神经、改善脑代谢等药物治疗,予神经肌肉电刺激治疗、吞咽训练和穴位按摩治疗,观察组加予耳穴磁疗,2组均连续治疗4周。治疗前、治疗4周后分别采用吞咽造影检查(VFSS)评分量表、渗漏-误吸评分量表(PAS)、吞咽障碍结局与严重度量表(DOSS)对患者的吞咽功能进行评定。比较2组的临床疗效、非经口管饲拔管率及误吸、误吸相关性肺炎发生率。结果:治疗4周,观察组临床疗效总有效率高于对照组(P<0.05)。2组VFSS评分、DOSS评分均较治疗前升高(P<0.05),PAS评分均较治疗前降低(P<0.05);观察组VFSS评分、DOSS评分均高于对照组(P<0.05),PAS评分低于对照组(P<0.05)。观察组拔管率高于对照组(P<0.05),误吸、误吸相关性肺炎发生率均低于对照组(P<0.05)。结论:耳穴磁疗联合常规疗法治疗神经性吞咽障碍可显著改善患者的吞咽功能,减少误吸及相关性肺炎的发生。Objective:To observe the clinical effect of auricular point magnetic therapy combined with routine therapy on neurogenic dysphagia.Methods:A total of 90 patients with neurogenic dysphagia were selected and divided into the control group and the observation group according to the random number table method,with 45 cases in each group.The two groups were given medicines for neuro nutrition and improvement of brain metabolism,neuromuscular electrical stimulation,swallowing training and points massage.The observation group was additionally treated with auricular point magnetic therapy.The two groups were treated for 4 weeks.Before treatment and after 4 weeks of treatment,the swallowing function of patients was evaluated by Video Fluorescence Swallowing Study(VFSS)scale,Penetration-Aspiration Scale(PAS)and Dysphagia Outcome and Severity Scale(DOSS).The clinical effects,and extubation rate of non-oral intubation feeding,aspiration and aspiration-associated pneumonia were compared between the two groups.Results:After 4 weeks of treatment,the total clinical effective rate in the observation group was higher than that in the control group(P<0.05).The scores of VFSS and DOSS in both groups were increased when compared with those before treatment(P<0.05),the PAS scores were decreased when compared with those before treatment(P<0.05);the scores of VFSS and DOSS in the observation group were higher than those in the control group(P<0.05),and the PAS score was lower than that in the control group(P<0.05).The extubation rate in the observation group was higher than that in the control group(P<0.05),and the incidences of aspiration and aspiration-associated pneumonia were lower than those in the control group(P<0.05).Conclusion:The auricular point magnetic therapy combined with routine therapy for neurogenic dysphagia can significantly improve the swallowing function of patients,and reduce the incidences of aspiration and aspiration-associated pneumonia.

关 键 词：神经性吞咽障碍 耳穴磁疗 吞咽训练 吞咽功能 

分 类 号：R741[医药卫生—神经病学与精神病学]