舌针联合康复训练治疗中风后口腔期吞咽障碍(气虚血瘀型)的临床研究  

Clinical Study on Tongue Acupuncture Combined with Rehabilitation Training in Treatment of Post-Stroke Dysphagia in Oral Stage(Syndrome of Qi Deficiency and Blood Stasis)

作　　者：陈志秀 毛忠南 张晓凌 谢亚青 李明 姚军孝 毛立亚 CHEN Zhixiu;MAO Zhongnan;ZHANG Xiaoling;XIE Yaqing;LI Ming;YAO Junxiao;MAO Liya(Gansu University of Chinese Medicine,Lanzhou 730000,China;Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃中医药大学附属医院,甘肃兰州730000

出　　处：《针灸临床杂志》2023年第5期31-36,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：甘肃省自然科学基金,编号:21JR11RA151;甘肃省卫生行业科研计划项目,编号:GSWSKY-2019-31。

摘　　要：目的:观察舌针联合康复训练治疗中风后口腔期吞咽障碍(气虚血瘀型)的临床疗效。方法:将符合纳入标准的64例患者随机分为治疗组和对照组,各32例。对照组给予吞咽康复训练,治疗组在此基础上加舌针为主的特定穴位治疗,取穴金津、玉液、海泉、聚泉、廉泉、气海与血海(双侧)。1次/d,每周6 d,共治疗4周。分别观察两组患者口腔传送时间(OTT)、吞咽障碍造影评分量表(VDS)评分、功能性经口摄食量表(FOIS)评级、标准吞咽功能评价量表(SSA)评分及中医证候评分治疗前后的变化,比较疗效差异。结果:治疗后,两组患者较治疗前OTT时间缩短(P<0.05),VDS评分、SSA评分和中医症候总评分降低,FOIS评分增加(P<0.05);且治疗组患者OTT、VDS评分、SSA评分、FOIS评级与中医证候总评分改善程度优于对照组(P<0.05)。结论:舌针联合康复训练可有效促进气虚血瘀型中风后口腔期吞咽障碍运动功能,从而改善整体吞咽行为协调性,联合干预疗效较单一治疗更优。Objective:To observe the clinical effect of tongue acupuncture combined with rehabilitation training in treatment of post-stroke dysphagia in oral stage(syndrome of Qi deficiency and blood stasis).Methods:A total of 64 patients,who met the inclusion criteria,were randomly divided into the treatment group and the control group,with 32 cases in each group.The control group was treated with swallowing rehabilitation training;on which basis,the treatment group was also treated with tongue acupuncture based on specific acupoints of Jinjin and Yuye(EX-HN12),Haiquan(EX-HN11),Juquan(EX-HN10),Lianquan(RN23),Qihai(RN6)and bilateral Xuehai(SP10).The treatment was once a day,6 days a week for 4 weeks in both groups.The changes in Oral Transit Time(OTT),Videofluoroscopic Dysphgia Scale(VDS),Functional Oral Intake Scale(FOIS),Standard Swallowing Assessment(SSA)and TCM symptom scores were observed before and after the treatment in the two groups.The clinical efficacy was compared between the two groups.Results:The OTT time of the two groups was shorter(P<0.05),the scores of VDS,SSA,and TCM symptoms were decreased,and the score of FOIS was increased after the treatment than those before the treatment in the two groups(P<0.05);of which the improvements in the treatment group were more significant than those in the control group(P<0.05).Conclusion:Tongue acupuncture combined with rehabilitation training can effectively promote the motor function of post-stroke dysphagia in oral stage(syndrome of Qi deficiency and blood stasis),so as to improve the coordination of overall swallowing behavior.The effect of combined intervention is better than that of single treatment.

关 键 词：中风 口腔期 吞咽障碍 舌针 康复训练 气虚血瘀证 

分 类 号：R246.6[医药卫生—针灸推拿学]