电针舌三针辅助星状神经节阻滞对脑梗死后吞咽障碍患者吞咽功能的影响  

Electroacupuncture with Tongue Three Needling Assists in Stellate Ganglion Block to Improve the Swallowing Function in Patients with Dysphagia after Cerebral Infarction

作　　者：赵鹏[1] 姚玉婷 贾贤达 肖志娟[1] 郜静[1] 刘敏肖[1] 沈文[1] ZHAO Peng;YAO Yu-ting;JIA Xian-da;XIAO Zhi-juan;GAO Jing;LIU Min-xiao;SHEN Wen(Department of Neurology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075100;Department of Function,The Second Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075100)

机构地区：[1]河北北方学院附属第二医院神经内科,河北张家口075100 [2]河北北方学院附属第二医院功能科,河北张家口075100

出　　处：《世界中西医结合杂志》2024年第1期140-144,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：张家口市2022年科技计划项目(2221046D)。

摘　　要：目的探讨电针舌三针辅助星状神经节阻滞(Stellate ganglion block,SGB)对脑梗死后吞咽障碍患者吞咽功能的影响。方法选取2022年1月—2023年1月期间河北北方学院附属第二医院收治的90例脑梗死后吞咽障碍患者,依据简单随机数字表法分为对照组和研究组,每组各45例。对照组采取SGB治疗,研究组在对照组基础上采取电针舌三针疗法,共治疗14 d。统计两组患者治疗前后舌骨移动度、吞咽用时、吞咽功能(Standardized swallowing assessment,SSA)及生活质量(Swallowing Quality-of-Life Instrument,SWAL-QOL)评分、营养状态指标[白蛋白(Prealbumin,PA)、转铁蛋白(Transferrin,TRF)、白蛋白(Albumin,ALB)]平及不良事件发生情况。结果治疗后两组患者舌骨上、下移动度较治疗前增大,差异有统计学意义(P<0.05);且研究组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者喉关闭用时、咽运送用时、口腔运送用时、吞咽反应用时较治疗前缩短,差异有统计学意义(P<0.05);且研究组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SSA评分较治疗前降低、SWAL-QOL评分较治疗前升高,差异有统计学意义(P<0.05);且研究组SSA评分低于对照组,SWAL-QOL评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者PA、ALB、TRF水平较治疗前升高,差异有统计学意义(P<0.05);且研究组高于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良事件发生率4.44%(2/45)明显低于对照组17.78%(8/45),差异有统计学意义(P<0.05)。结论采取电针舌三针辅助SGB治疗脑梗死后吞咽障碍可增大舌骨移动度,缩短吞咽用时,利于改善吞咽功能及营养状态,提升生活质量,并降低不良事件发生风险。Objective To explore the effect of electroacupuncture with tongue three needling combined with stellate ganglion block(SGB)on the swallowing function in the patients with dysphagia after cerebral infarction.Methods Ninety patients with dysphagia after cerebral infarction treated in the Second Affiliated Hospital of Hebei North University from January 2022 to January 2023 were assigned into a study group and a control group according to the simple random number table,with 45 patients in each group.The control group was treated with SGB,and the study group was treated with electroacupuncture with tongue three needling on the basis of the therapy in the control group.The treatment in both groups lasted for a total of 14 days.The hyoid bone mobility,swallowing time,standardized swallowing assessment(SSA)score,swallowing quality-of-life instrument(SWAL-QOL)score,and levels of nutritional status indicators[prealbumin(PA),transferrin(TRF),and albumin(ALB)]were determined before and after treatment.The adverse events occurred in both groups were recorded.Results After treatment,the upward and downward mobility of the hyoid bone in both groups of patients increased(P<0.05),and the mobility in the study group was greater than that in the control group(P<0.05).After treatment,the throat closure time,pharyngeal transport time,oral transport time,and swallowing reaction time of the two groups of patients became shortened compared with those before treatment(P<0.05),and the time in the study group was shorter than that in the control group(P<0.05).The treatment in both groups decreased the SSA score and increased the SWAL-QOL score(P<0.05),and the study group had lower SSA score and higher SWAL-QOL score than the control group after treatment(P<0.05).After treatment,the levels of PA,ALB,and TRF in the two groups elevated(P<0.05),and the levels of PA,ALB,and TRF in the study group were higher than those in the control group(P<0.05).The incidence of adverse events in the study group was 4.44%(2/45),which was lower than that(17.7

关 键 词：电针 舌三针 星状神经节阻滞 脑梗死 吞咽障碍 吞咽功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]