人迎寸口脉针法联合肝豆汤治疗肝豆状核变性吞咽障碍的疗效观察  

Observations on the efficacy of Renying-Cunkou pulse acupuncture plus Gan Dou Tang for dysphagia in hepatolenticular degeneration

作　　者：裴培[1] 陈怀珍[1] 黄智姜 崔圣玮 张宇[3] 杨文明[1] PEI Pei;CHEN Huaizhen;HUANG Zhijiang;CUI Shengwei;ZHANG Yu;YANG Wenming(Anhui University of Traditional Chinese Medicine First Hospital,Hefei 230031,China;Guangxi International Zhuang Medical Hospital,Nanning 530000,China;Anhui University of Traditional Chinese Medicine,Hefei 230012,China)

机构地区：[1]安徽中医药大学第一附属医院,合肥230031 [2]广西国际壮医医院,南宁530000 [3]安徽中医药大学,合肥230012

出　　处：《上海针灸杂志》2023年第7期699-704,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(81803903);安徽中医药大学临床科研项目(2021yfylc22)。

摘　　要：目的观察人迎寸口脉针法联合肝豆汤治疗湿热内蕴型肝豆状核变性(hepatolenticular degenera-tion,HLD)吞咽障碍的临床疗效。方法将60例湿热内蕴型HLD吞咽障碍患者随机分为对照组和治疗组,每组30例。对照组予常规排铜治疗,治疗组在对照组治疗基础上予人迎寸口脉针法联合肝豆汤治疗。采用洼田饮水试验(water swallow test,WST)、标准吞咽功能评价量表(standardized swallowing assessment,SSA)及吞咽生活质量问卷(swallow quality of life questionnaire,SWAL-QOL)评价吞咽功能及生活质量,同时检测24 h尿铜及血清同型半胱氨酸(homocysteine,Hcy)水平,并比较两组临床疗效。结果治疗后,两组WST及SSA评分较治疗前降低(P<0.01),SWAL-QOL评分较治疗前升高(P<0.01);治疗组WST及SSA评分低于对照组(P<0.01),SWAL-QOL评分高于对照组(P<0.01)。治疗后,两组24 h尿铜水平较治疗前升高(P<0.01),且治疗组高于对照组(P<0.01)。治疗组治疗后血清Hcy水平低于治疗前和对照组(P<0.01,P<0.05),对照组治疗前后无明显变化(P>0.05)。两组总有效率和痊愈率比较,差异无统计学意义(P>0.05)。结论在常规排铜治疗基础上,人迎寸口脉针法联合肝豆汤能显著改善湿热内蕴型HLD患者的吞咽功能及生活质量,促进铜排出,升高血清Hcy。Objective To observe the clinical efficacy of Renying-Cunkou pulse acupuncture plus Gan Dou Tang for dysphagia in hepatolenticular degeneration(HLD)of internal damp-heat accumulation type.Method Sixty patients with HLD dysphagia of internal damp-heat accumulation type were randomized to control and treatment groups,with 30 cases in each group.The control group received conventional copper removal therapy and the treatment group,Renying-Cunkou pulse acupuncture plus Gan Dou Tang in addition.Water swallow test(WST),the standardized swallowing assessment(SSA)and the swallow quality-of-life questionnaire(SWAL-QOL)were used to assess the swallowing function and the quality of life.Twenty-four hour urine copper levels and serum homocysteine(Hcy)levels were measured at the same time.Result After treatment,the WST and SSA scores in the two groups compared with before decreased(P<0.01)and the SWAL-QOL score increased(P<0.01);the WST and SSA scores were lower in the treatment group than in the control group(P<0.01)and the SWAL-QOL score was higher(P<0.01).After treatment,the 24-hour urine copper levels increased in the two groups compared with before(P<0.05)and was higher in the treatment group than in the control group(P<0.01).After treatment,the serum Hcy levels decreased in the treatment group and were lower than that in the control group(P<0.01,P<0.05),and did not change significantly in the control group(P>0.05)compared with before.The total efficacy rate and the cure rate had no statistically significant differences between the two groups(P>0.05).Conclusion On the basis of copper removal therapy,Renying-Cunkou pulse acupuncture plus Gan Dou Tang can markedly improve the swallowing function and the quality of life,promote copper removal and increase serum Hcy in patients with HLD of internal damp-heat accumulation type.

关 键 词：针刺疗法 针药并用 人迎寸口脉针法 肝豆状核变性 吞咽障碍 湿热内蕴 

分 类 号：R246.6[医药卫生—针灸推拿学]