揿针联合开窍利咽按摩法对缺血性卒中吞咽障碍患者吞咽功能评价量表和功能性经口摄食量表评分的影响  

Effects of thumbtack needle combined with Kaiqiao Liyan massage method on scores of swallowing function assessment scale and functional oral food intake scale in ischemic stroke patients with dysphagia

作　　者：颜维 董庭瑄 崔亚 邓海鹏 YAN Wei;DONG Tingxuan;CUI Ya;DENG Haipeng(Department Rehabilitation,Haian People's Hospital,Haian,Jiangsu 226600)

机构地区：[1]江苏省海安市人民医院康复科,江苏海安226600

出　　处：《河北中医》2023年第9期1521-1525,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省卫生健康委医学科研项目(编号:Z2019033)。

摘　　要：目的 观察揿针联合开窍利咽按摩法对缺血性卒中吞咽障碍患者吞咽功能评价量表(SSA)评分和功能性经口摄食量表(FOIS)评分的影响。方法 将120例缺血性卒中吞咽障碍患者按照随机数字表法分为2组,对照组60例予神经肌肉电剌激+吞咽训练治疗,治疗组60例在对照组治疗基础上应用揿针联合开窍利咽按摩法治疗,2组均治疗2周。比较2组疗效;比较2组治疗前后SSA评分、FOIS评分、Rosenbek渗透-误吸量表(PAS)评分、吞咽障碍特异性生活质量量表(SWAL-QOL)评分;比较2组治疗前后脑血流动力学变化;比较2组治疗前后脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)变化。结果 治疗组总有效率96.67%(58/60),对照组总有效率86.67%(52/60),治疗组疗效优于对照组(P<0.05)。2组治疗后SSA评分、PAS评分均较本组治疗前降低(P<0.05),FOIS评分、SWAL-QOL评分均较本组治疗前升高(P<0.05);治疗后治疗组SSA评分、PAS评分均低于对照组(P<0.05),FOIS评分、SWAL-QOL评分均高于对照组(P<0.05)。2组治疗后大脑前动脉(ACA)、大脑中动脉(MCA)、椎动脉(VA)、基底动脉(BA)的收缩期峰流速(Vs)、舒张期峰流速(Vm)均较本组治疗前升高(P<0.05),血管搏动指数(PI)均较本组治疗前降低(P<0.05);治疗后治疗组ACA、MCA、VA、BA的Vs、Vm均高于对照组(P<0.05),PI低于对照组(P<0.05)。2组治疗后BDNF、NGF均较本组治疗前升高(P<0.05),NSE较本组治疗前降低(P<0.05);治疗后治疗组BDNF、NGF均高于对照组(P<0.05),NSE低于对照组(P<0.05)。结论 揿针联合开窍利咽按摩法治疗缺血性卒中吞咽障碍,可增加患者脑部供血,调节神经相关因子表达,改善生活质量和吞咽功能。Objective To observe the effect of thumbtack needle combined with Kaiqiao Liyan massage method on the scores of swallowing function assessment scale(SSA)and functional oral food intake scale(FOIS)in patients with ischemic stroke dysphagia.Methods A total of 120 ischemic stroke patients with dysphagia were randomly enrolled into the control group(n=60)and the treatment group(n=60).The treatment group were additionally treated with the combination of thumbtack needle and Kaiqiao Liyan massage method on the basis of routine treatment.Both groups were treated for 2 weeks.The differences in the scores of SSA,FOIS,Rosenbek Permeation-Aspiration Scale(PAS)and swallowing quality of life(SWAL-QOL)were compared between groups before and after treatment.The changes of cerebral hemodynamics including brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE)and nerve growth factor(NGF)were recorded.Results There were significant differences in the score of SSA and PAS,FOIS and SWAL-QOL between groups(all P<0.05).The total effective rate in the observation group was significantly higher than that in the control group(96.67%[58/60]vs 86.67%[52/60],P<0.05).After treatment,SSA and PAS scores in the two groups were significantly decreased(P<0.05),while FOIS and SWAL-QOL scores were significantly increased(P<0.05).There were significant differences in SSA,PAS,FOIS and SWAL-QOL scores between groups(all P<0.05).The systolic blood flow velocity(Vs)and average blood flow velocity(Vm)of the cerebral arteries in the two groups were significantly increased(P<0.05),while the pulsatility index(PI)was significantly decreased(P<0.05).The values of cerebral hemodynamic indexes in the group were better than those in the control group(P<0.05).BDNF and NGF in both groups were significantly higher(P<0.05),while NSE was significantly lower(P<0.05),and BDNF,NGF and NSE in the observation group were better than those in the control group(P<0.05).Conclusion For ischemic stroke patients with dysphagia,the combination can increase the brain

关 键 词：缺血性卒中 吞咽障碍 针刺疗法 按摩 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R245.31[医药卫生—临床医学] R244.1