针灸不同穴位组治疗中风后假性球麻痹吞咽功能障碍疗效研究  

Curative effect study on different acupuncture point on swallowing dysfunction caused by pseudobulbar palsy after stroke

作　　者：梁艳桂[1] 吴海科[1] 黄耀渠[1] 黄婷婷[1] 黄强 刘亚丽[1] 张明霞[1] 黎力生[1] 胡泳端 LIANG Yangui;WU Haike;HUANG Yaoqu;HUANG Tingting;HUANG Qiang;LIU Yali;ZHANG Mingxia;LI Lisheng;HU Yongduan(Department of Encephalopathy,Foshan Hospital of Traditional Chinese Medicine,Foshan 528051,China)

机构地区：[1]佛山市中医院脑病科,广东佛山528051

出　　处：《陕西中医》2024年第3期411-415,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20241300,20212220)。

摘　　要：目的:分析针灸不同穴位组对中风后假性球麻痹吞咽功能障碍的治疗效果。方法:将90例中风后假性球麻痹吞咽功能障碍患者分为常规组、项针组、舌针组,每组30例,治疗14 d。比较各组治疗14 d后的疗效,治疗前、治疗14 d后营养指标、梗死灶多模态磁共振参数、吞咽功能相关指标、症状改善情况。结果:治疗14 d后,舌针组总有效率高于项针组、常规组(P<0.05)。治疗14 d后,各组血清白蛋白(ALB)、前白蛋白(PAD)、血红蛋白(Hb)、N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、N-乙酰天门冬氨酸与(胆碱+肌酸)比值、韦氏成人智力量表评分高于治疗前,且舌诊组最高,差异有统计学意义(均P<0.05)。各组Cho/Cr、标准吞咽功能评价量表(SAA)、洼田饮水试验评分、洼田饮水试验前后脉冲血氧饱和度下降值、美国国立卫生研究院卒中量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表评分低于治疗前,且舌诊组最低,差异有统计学意义(均P<0.05)。结论:与常规治疗或项针治疗相比,舌针治疗中风后假性球麻痹吞咽功能障碍能更有效地改善患者营养状态、梗死灶多模态磁共振参数、吞咽功能及临床症状。Objective:To analyze effect of acupuncture and moxibustion on patients with pseudobulbarpalsy swallowing dysfunction afterstroke.Methods:90 patients with poststroke pseudobulbar palsy swallowing dysfunction were divided into routine treatment group,needle treatment group and tongue acupuncture group by random numbertable method,with 30 cases in each group treated foR14 days.The therapeutic effect of the three groups after14 day treatment,and the nutritional indexes,multimodal magnetic resonance parameters of infarction,related indexes of swallowing function and symptom improvement of the three groups were compared before and after14 days treatment.Results:AfteR14 days treatment,the total effective rate of the tongue acupuncture group was higheRthan that in the needle acupuncture group and the conventional group(P<0.05).AfteR14 days treatment,levels of serum albumin,prealbumin,hemoglobin,N-acetylaspartate/creatine,NAA/[Choline(Cho)+Cr]and score of WechsleRadult intelligence scale of the three groups were increased compared with before treatment,the tongue acupuncture group were the highest,difference statistically significant(all P<0.05).Cho/Cr,scores of Standard,depression of pulse oxygen saturation before and afterdepression drinking test,NIHSS HAMA and HAMD all decreased in the three groups compared with those before treatment,the tongue acupuncture group was the lowest,difference statistically significant(all P<0.05).Conclusion:Compared with conventional therapy oRacupuncture therapy,tongue acupuncture therapy could effectively improve nutritional status,multimodal magnetic resonance parameters of infarction,swallowing function and clinical symptoms of patients with pseudobulbarpalsy afterstroke.

关 键 词：中风 假性球麻痹 吞咽功能障碍 针灸 项针 舌针 多模态磁共振 

分 类 号：R255.2[医药卫生—中医内科学]