项针治疗脑卒中后咽期吞咽障碍疗效观察  

Efficacy of neck acupuncture on post-stroke oropharyngeal dysphagia

作　　者：张世强 朱路文[1,2] 李宏玉[1,2] 梁碧莹 王雪 唐强 ZHANG Shiqiang;ZHU Luwen;LI Hongyu;LIANG Biying;WANG Xue;TANG Qiang(Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,Heilongjiang,China;The Second Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine,Harbin 150000,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150000

出　　处：《现代中西医结合杂志》2023年第8期1053-1057,1062,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家重点研发计划项目(2019YFC1710304)。

摘　　要：目的 比较项针疗法与吞咽康复训练治疗脑卒中后咽期吞咽障碍患者的疗效。方法 招募2019年12月—2022年3月在黑龙江中医药大学附属第二医院康复科治疗的脑卒中后咽期吞咽障碍患者,采用计算机软件SAS 9.3将受试者分为试验组和对照组,试验组给予项针疗法治疗,对照组给予吞咽康复训练,均每日1次,每周6次,共治疗3周。比较2组患者治疗前及治疗3周后标准吞咽功能评估(SSA)量表、吞咽生命质量(SWAL-QOL)量表、吞咽造影(VFSS)评价量表评分及咽侧壁活动度。结果 共纳入72例受试者,研究期间脱落7例;治疗后,2组患者的SSA评分均较治疗前明显降低(P均<0.05),且试验组患者SSA评分明显低于对照组(P<0.05);2组患者的SWAL-QOL评分均较治疗前明显升高(P均<0.05),且试验组患者SWAL-QOL评分明显高于对照组(P<0.05);2组患者在进食3种不同性状食物时的VFSS评分均较治疗前明显提高(P均<0.05),且试验组患者的VFSS评分均明显高于对照组(P均<0.05);2组患者吞咽时的咽侧壁运动幅度、运动速度均提高,运动时间均明显缩短,且试验组患者咽侧壁的运动幅度、运动速度提高更显著,运动时间缩短更明显,差异均有统计学意义(P均<0.05)。结论 项针疗法可以改善脑卒中后咽期吞咽障碍患者的吞咽功能,提高患者的生活质量和咽部的吞咽运动功能,且疗效优于吞咽康复训练。Objective It is to compare the efficacy of neck acupuncture therapy and swallowing rehabilitation training in the treatment of patients with post-stroke oropharyngeal dysphagia.Methods The patients with post-stroke oropharyngeal dysphagia treated at the Department of Rehabilitation of the Second Hospital of Heilongjiang University of Traditional Chinese Medicine from December 2019 to March 2022 were recruited,and the subjects were divided into a test group and a control group using the computer software SAS 9.3.The test group was treated with neck acupuncture therapy,and the control group was given swallowing rehabilitation training,both once daily,six times per week,totally treated for 3 weeks.The scores of standard swallowing assessment(SSA)scale,swallowing quality of life(SWAL-QOL)scale,videofluoroscopic swallowing study(VFSS)evaluation scale and movement of lateral pharyngeal wall before and after 3 weeks of treatment were compared between the two groups.Results A total of 72 subjects were included,and 7 cases were shed during the study period.After treatment,the SSA scores of patients in both groups were significantly lower than those before treatment(all P<0.05),and the SSA scores of patients in the test group were significantly lower than those in the control group(all P<0.05);the SWAL-QOL scores of patients in both groups were significantly higher than those before treatment(all P<0.05),and the SWAL-QOL scores of patients in the test group were significantly higher than those in the control group(all P<0.05);the VFSS scores of patients when eating the food of 3 kinds of characteristics in both groups were significantly higher than those before treatment(all P<0.05),and the VFSS scores of patients in the test group were significantly higher than those in the control group(all P<0.05);the amplitude and speed of movement of the lateral pharyngeal wall of the patients in both groups during swallowing were increased and the movement time was significantly shortened,and the increase of the amplitude and speed o

关 键 词：脑卒中 吞咽障碍 项针 吞咽康复训练 

分 类 号：R743.33[医药卫生—神经病学与精神病学]