神经营养类类药物与头针缓解脑卒中后吞咽功能障碍的作用  

The effect of neurotrophic drugs and scalp acupuncture on relieving swallowing dysfunction after stroke

作　　者：秦彦武 谢雪 莫仁姣 QIN Yanwu;XIE Xue;MO Renjiao(Department of Rehabilitation Medicine,Yubei District People’s Hospital,Chongqing 401120,China)

机构地区：[1]重庆市渝北区人民医院康复医学科,重庆401120

出　　处：《四川中医》2024年第8期180-184,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：重庆市科卫联合中医药科研项目(项目编号:2019ZY023397)。

摘　　要：目的:探究神经营养类药物与头顶针联合治疗在脑卒中后吞咽功能障碍患者中的临床疗效。方法:选取我院2019年10月~2023年10月就诊的脑卒中后吞咽功能障碍患者260例,将符合纳入标准的研究对象依据数字随机分组法分为对照组和中西医治疗组。对照组采用神经营养类药物等基础治疗方法,中西医治疗组采用联合治疗方法。观察指标包括吞咽功能、精神状态、表面肌电图、总生存期(Overall Survival,OS)、无进展生存期(Progression-free Survival,PFS)。结果:两组患者的性别、年龄、病程、体质量指数(Body Mass Index,BMI)均无统计学差异(P>0.05)。两组脑卒中后吞咽功能障碍治疗前洼田饮水试验评分、抑郁自评量表(Self-Rating Depression Scale,SDS)和焦虑自评量表(Self-rating Anxiety Scale,SAS)评分、空吞咽和吞咽5mL水的平均振幅值和持续时间无统计学差异(P>0.05)。对比治疗前,治疗1周、2周、4周后,两组患者的相应评分有差异或显著差异(P<0.05或P<0.001)。相比对照组,中西医治疗组在治疗1周、2周、4周后的相应评分有差异或显著差异(P<0.05或P<0.001)。结论:神经营养类药物与头顶针能极大程度缓解脑卒中后吞咽功能障碍,同时还能改善精神状态和表面肌电图测试指标,进而延长患者的生存周期。Objective To explore the clinical efficacy of combination therapy of neurotrophic drugs and scalp acupuncture in patients with post-stroke swallowing dysfunction.Method:260patients with post-stroke swallowing dysfunction who visited our hospital from October 2019to October 2023were selected.The study subjects who met the inclusion criteria were randomly divided into a control group and a traditional Chinese and Western medicine treatment group using a digital randomization method.The control group received basic treatment methods such as neurotrophic drugs,while the traditional Chinese and Western medicine treatment group received combined treatment.Observation indicators include swallowing function,mental state,surface electromyography,overall survival(OS),and progression free survival(DFS).There was no statistically significant difference(P<0.05)in gender,age,course of disease,and Body Mass Index(BMI)between the two groups of patients.There was no statistically significant difference(P>0.05)in the scores of the Wada drinking water test,SDS and SAS scales,as well as the average amplitude and duration of empty swallowing and swallowing 5ml of water before treatment for post-stroke swallowing dysfunction between the two groups.There is a difference or significant difference(P<0.05or P<0.001)in the corresponding scores between the two groups of patients before and after 1,2,and 4weeks of treatment.Compared with the control group,the corresponding scores of the Chinese and Western medicine treatment group showed differences or significant differences(P<0.05or P<0.001)after 1,2,and 4weeks of treatment.Taking follow-up time 2as an example,the OS rates of the control group and the study group were 65.12%and 79.26%,respectively,and the DFS rates were 58.28%and 68.17%,respectively.There was a significant statistical difference between the two groups(P<0.001).Conclusion:Neuronutritional drugs and scalp acupuncture can greatly alleviate swallowing dysfunction after stroke,while also improving mental state and surface elect

关 键 词：脑卒中 头顶针 吞咽功能障碍 表面肌电图 神经营养类药物 

分 类 号：R246.6[医药卫生—针灸推拿学]