通督益脑化痰法结合针刺治疗急性缺血性卒中吞咽障碍痰瘀阻络证疗效观察  

Rehabilitation Effect of Dredging Du Meridian,Supplementing Brain and Resolving Phlegm Method Combined with Acupuncture in Acute Ischemic Stroke Patients with Dysphagia of Phlegm and Blood Stasis Blocking Collateral Syndrome

作　　者：许长敏 刘宏伟 周媛 张小健 张媛 柳淑青 刘晶晶 XU Changmin;LIU Hongwei;ZHOU Yuan;ZHANG Xiaojian;ZHANG Yuan;LIU Shuqing;LIU Jingjing(Department of Encephalopathy,Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101399,China)

机构地区：[1]北京中医医院顺义医院脑病科,北京101399

出　　处：《辽宁中医杂志》2024年第8期91-94,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：北京市医管局培育计划项目(PZ2020021)。

摘　　要：目的探讨通督益脑化痰法结合针刺促进急性缺血性卒中吞咽障碍痰瘀阻络证患者康复效果。方法研究纳入112例急性缺血性卒中吞咽障碍痰瘀阻络证患者以随机数字表法纳入患者分为对照组(56例)、中医组(56例),给予对照组患者咽部肌肉电刺激治疗,给予中医组患者咽部肌肉电刺激结合通督益脑化痰法及针刺治疗,各组数据观察:治疗前后患者洼田饮水试验评分(water test score,WST)变化及功能性经口摄食量表(functional oral feeding scale,FOIS)评分变化、吞咽困难评价量表(dysphagia evaluation scale,VFSS)及标准吞咽功能评价量表(standard swallowing function evaluation scale,SSA)评分变化、治疗效果、并发症、治疗前后患者中医证候总积分及美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分变化、治疗,前后患者脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)及白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平变化、生活质量量表(generic quality of life inventory-74,GQOLI-74)评分变化。结果治疗前,各组患者WST评分、FOIS评分、VFSS评分、SSA评分、中医证候总积分以及NIHSS评分、BDNF、IL-6及TNF-α水平、GQOLI-74评分等指标比较,差异无统计学意义(P>0.05),治疗后各组患者WST评分、FOIS评分、VFSS评分、SSA评分、中医证候总积分以及NIHSS评分、BDNF、IL-6及TNF-α水平、GQOLI-74评分等指标均改善,中医组患者治疗后WST评分、FOIS评分、VFSS评分、SSA评分、中医证候总积分以及NIHSS评分、BDNF、IL-6及TNF-α水平、GQOLI-74评分等指标均优于对照组(P<0.05);中医组患者治疗总有效率高于对照组,并发症发生率低于对照组(均P<0.05)。结论通督益脑化痰法结合针刺疗法可较好促进急性缺血性卒中吞咽障碍痰瘀阻络证患者康复,患者治疗效果提升,吞咽功能及神经功能、生活质量�Objective To explore the rehabilitation effect of dredging Du meridian,supplementing brain and resolving phlegm method combined with acupuncture in acute ischemic stroke patients with dysphagia of phlegm and blood stasis blocking collateral syndrome.Methods A total of 112 acute ischemic strok epatients with dysphagia of phlegm and blood stasis blocking collateral syndrome were included in this study.The patients were divided into control group(56 cases)and traditional Chinese medicine group(56 cases)by random number table method.The patients in the control group were given pharyngeal muscle electrical stimulation,and those in the traditional Chinese medicine group were given pharyngeal muscle electrical stimulation combined with dredging Du meridian,supplementing brain and resolving phlegm method and acupuncture treatment.The changes of depression water test score(WST),Functional Oral Feeding Scale(FOIS)score,dysphagia Evaluation Scale(VFSS)and Standard Swallowing Function Evaluation Scale(SSA)score before and after treatment,the effect,complications,total scores of TCM syndrome before and after treatment and National Institutes of Health Stroke Scale(NIHSS),the changes of brain-derived neurotrophic factor(BDNF),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and the score of quality of Life scale(Generic Quality of Life Inventory-74,GQOLI-74)before and after treatment were compared.Results Before treatment,WST score,FOIS score,VFSS score,SSA score,total TCM syndrome score,NIHSS score,the levels of BDNF,IL-6 and TNF-α,GQOLI-74 score and other indexes were not significant in two groups(P>0.05).After treatment,WST score,FOIS score,VFSS score,SSA score,total TCM syndrome score,NIHSS score,the levels of BDNF,IL-6 and TNF-α,GQOLI-74 score and other indicators were all improved in two groups.And the above indexes in the traditional Chinese medicine group were better than those in control group(P<0.05).The total effective rate of the traditional Chinese medicine group was higher than that of control group,and the

关 键 词：通督益脑化痰法 痰瘀阻络证 针刺 急性缺血性卒中吞咽障碍 咽部肌肉电刺激 疗效 吞咽功能 并发症 

分 类 号：R255.2[医药卫生—中医内科学]