徒手呼吸训练联合电针穴位刺激治疗脑卒中后吞咽障碍的疗效  

Effect of Unarmed Respiratory Function Training Combined with Electroacupuncture on Dysphagia after Stroke

作　　者：景荣华 周益凡 孙云丰 张云云 廖军 JING Rong-hua;ZHOU Yi-fan;SUN Yun-feng;ZHANG Yun-yun;LIAO Jun(Department of Rehabilitation,Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830000)

机构地区：[1]新疆维吾尔自治区中医医院康复科,新疆乌鲁木齐830000

出　　处：《世界中西医结合杂志》2023年第4期737-741,746,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：新疆医科大学附属中医医院院级课题(ZYY202016)。

摘　　要：目的 探讨徒手呼吸训练联合电针穴位刺激治疗脑卒中后吞咽障碍的临床疗效。方法 选取2021年2月—2021年12月期间新疆维吾尔自治区中医医院康复科收治的脑卒中后吞咽障碍患者98例,按随机数表法分为对照组和观察组,每组各49例。对照组进行常规康复训练,观察组在对照组基础上增加徒手呼吸训练和电针穴位刺激。治疗6周后,观察比较两组患者洼田饮水试验疗效,治疗前后进食评估量表评分(Eating assessment tool-10,EAT-10)、功能性经口摄食表评级(Functional oral intake scale, FOIS)、呼吸功能指标[用力肺活量(Forced vital capacity, FVC)、每分钟最大通气量(Maximum voluntary ventilation, MVV)、呼吸频率(Breathe frequency, BF)]及Rosenbek误吸程度评级变化情况。结果 治疗后两组患者EAT-10评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组患者EAT-10评分低于对照组,差异有统计学意义(P<0.05)。治疗后观察组洼田饮水试验总有效率91.84%(45/49)明显高于对照组71.43%(35/49),差异有统计学意义(P<0.05)。治疗后两组患者FOIS评级均较治疗前明显上调,差异有统计学意义(P<0.05);且观察组评级改善程度明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者呼吸功能指标FVC、MVV水平均较治疗前升高,BF水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组患者FVC、MVV水平高于对照组,BF水平低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Rosenbek误吸程度分级评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组患者Rosenbek误吸程度分级评分低于对照组,差异有统计学意义(P<0.05)。结论 电针穴位刺激联合徒手呼吸训练可有效改善脑卒中后吞咽障碍患者的吞咽功能及呼吸功能,临床应用效果显著。Objective To explore the clinical effect of unarmed respiratory function training combined with elec-troacupuncture on dysphagia after stroke.Methods A total of 98 patients with dysphagia after stroke treated in the De-partment of Rehabilitation of the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from Febru-ary to December in 2021 were randomly assigned into a control group(n=49)and an observation group(n=49).The control group received routine rehabilitation training,and the observation group additionally received unarmed respiratory function training and electroacupuncture.The treatment lasted for 6 weeks,and then Kubota water swallowing test was con-ducted to compare the clinical efficacy between the two groups.The eating assessment tool-10(EAT-10)score,function-al oral intake scale(FOIS)score,forced vital capacity(FVC),maximum voluntary ventilation(MVV),breathing frequen-cy(BF),and Rosenbek′s penetration-aspiration scale score were determined before and after treatment in the two groups.Results After treatment,the EAT-10 scores of patients in both groups decreased compared to those before treat-ment,and the EAT-10 scores of patients in the observation group were lower than those in the control group(P<0.05).The Kubota water swallowing test showed that the total effective rate in the observation group was 91.84%(45/49),which was higher than that(71.43%,35/49)in the control group(P<0.05).After treatment,the FOIS scores in both groups increased compared with those before treatment and were higher in the observation group than in the control group(P<0.05).The treatment in both groups increased FVC and MVV and lowered BF.Moreover,the observation group had higher FVC and MVV and lower BF than the control group(P<0.05).After treatment,the Rosenbek′s penetration-aspiration scale scores in both groups declined compared with those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).Conclusion Electroacupuncture combined with unarmed

关 键 词：电针穴位刺激 徒手呼吸训练 脑卒中 吞咽障碍 

分 类 号：R245.97[医药卫生—针灸推拿学] R743.3[医药卫生—中医临床基础]