舌三针为主针刺辅助治疗脑卒中后吞咽障碍的临床研究  

Clinical Study on Tongue Triple Acupuncture as Main Acupuncture in Adjuvant Treatment of Post-Stroke Dysphagia

作　　者：黄炎 王群 王康 姚彦 HUANG Yan;WANG Qun;WANG Kang;YAO Yan(Department of Rehabilitation,Huainan Oriental Hospital Group General Hospital,Huainan 232001,Anhui,China;Department of Rehabilitation,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232001,Anhui,China)

机构地区：[1]淮南东方医院集团总医院康复科,安徽淮南232001 [2]安徽理工大学第一附属医院康复科,安徽淮南232001

出　　处：《辽宁中医杂志》2023年第7期194-198,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81774111);中医重点专科培育项目:上海市进一步加快中医药事业发展三年行动计划(2018—2020年)-中医心病专科。

摘　　要：目的观察舌三针为主针刺辅助治疗脑卒中后吞咽障碍患者的临床疗效。方法选取2018年2月—2021年2月期间我院门诊加住院患者收治的85例脑卒中后吞咽障碍患者,按照就诊先后顺序将患者分为治疗组(n=43)和对照组(n=42),两组患者均依据个体化原则给予基础对症治疗和康复训练,对照组给予常规针刺治疗,治疗组加用舌三针,均治疗4周,观察两组患者治疗前后洼田饮水试验、才藤7级试验评价、藤岛一郎吞咽疗效评分和营养状况指标[血清白蛋白(ALB)、血红蛋白(Hb)]水平,对比两组患者临床疗效及不良事件发生率。结果治疗前,两组患者洼田饮水试验和才藤7级试验评价无统计学差异(P>0.05),治疗后两组洼田饮水试验评级均较治疗前降低,才藤7级试验评价较治疗前升高(P<0.05),且治疗组饮水试验评价显著低于对照组(P<0.05),才藤7级试验评价显著高于对照组(P<0.05)治疗前,两组患者藤岛一郎吞咽疗效评分无统计学差异(P>0.05),治疗后两组评分均较治疗前升高(P<0.05),且治疗组显著高于对照组(P<0.05)。治疗前,两组患者ALB、Hb水平无统计学差异(P>0.05),治疗后两组ALB、Hb水平均较治疗前升高(P<0.05),且治疗组显著高于对照组(P<0.05)。治疗组患者总有效率为95.35%,显著高于对照组的80.95%(P<0.05)。两组不良事件总发生率比较,无明显统计学差异(P>0.05)。结论舌三针为主针刺辅助治疗可有效改善脑卒中患者卒中后吞咽功能和营养状态,且安全性较好,值得临床推广使用。Objective To observe the clinical efficacy of tongue triple acupuncture as the main acupuncture in the adjuvant treatment of patients with post-stroke dysphagia.Methods Eighty-five patients with post-stroke dysphagia treated in outpatient department of the hospital were selected between February 2018 and February 2021,and they were divided into treatment group(43 cases)and control group(42 cases)according to the order of visits.The two groups were given the basic symptomatic treatment and rehabilitation training based on the principle of individualization,and the control group received conventional acupuncture treatment,and the treatment group was additionally given tongue triple acupuncture.Both groups were treated for 4 weeks.Water swallow test,Saito 7-grade test evaluation,Ichiro Fujishima swallowing efficacy score and nutritional status indicators[serum albumin(ALB),hemoglobin(Hb)]of the two groups were observed before and after treatment.The clinical efficacy and incidence rates of adverse events were compared between the two groups.Results Before treatment,there were no statistical differences in the ratings of water swallow test or Saito 7-grade test between the two groups(P>0.05).After treatment,the water swallow test rating of the two groups was reduced compared with that before treatment while the Saito 7-grade test rating was elevated compared to that before treatment(P<0.05),and the water swallow test rating in the treatment group was significantly lower than that in the control group(P<0.05)while the Saito 7-grade test rating was significantly higher than that in the control group(P<0.05).There was no statistical difference in Ichiro Fujishima swallowing efficacy score between the two groups before treatment(P>0.05),and the scores of the two groups were enhanced after treatment compared to those before treatment(P<0.05),and the score was significantly higher in the treatment group than that in the control group(P<0.05).Before treatment,the differences in the levels of ALB and Hb were not statisticall

关 键 词：舌三针 针刺疗法 脑卒中 吞咽障碍 洼田饮水试验 

分 类 号：R246[医药卫生—针灸推拿学]