靳三针联合康复训练在脑卒中后假性球麻痹吞咽功能障碍中的应用价值研究  

Application Value of Jin's Three-Needle Combined with Rehabilitation Training on Swallowing Dysfunction of PBP after Cerebral Apoplexy

作　　者：张坤[1] 洪锋[1] 郑琦[1] ZHANG Kun;HONG Feng;ZHENG Qi(Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院,安徽亳州236800

出　　处：《针灸临床杂志》2024年第10期22-26,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：安徽省中医药传承创新科研项目,编号:2002CCZD07。

摘　　要：目的:探究靳三针联合康复训练在脑卒中(CA)后假性球麻痹(PBP)吞咽功能障碍中的应用价值。方法:将符合纳入标准的92例CA后PBP吞咽功能障碍患者进行研究,按照简单随机法分为观察组和对照组各46例,对照组给予康复训练治疗,观察组行康复训练及靳三针治疗,比较两组临床疗效、吞咽功能、舌喉吞咽能力[改良曼恩吞咽能力评估量表(MMASA)]、血清神经性因子水平及不良反应。结果:观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);治疗两周后,两组洼田饮水试验分级及评分均显著降低,差异有统计学意义(P<0.05),MMASA各维度评分、血清NGF、BDNF及IGF-1水平均显著升高,差异有统计学意义(P<0.05),NSE水平显著降低(P<0.05),且组间比较差异有统计学意义(P<0.05);治疗期间,两组患者均无明显不良反应。结论:CA后PBP吞咽功能障碍患者采用靳三针、康复训练联合治疗临床疗效可观,患者舌喉吞咽能力、神经功能均明显改善。Objective:To explore the application value of Jin's three-needle combined with rehabilitation training in treating swallowing dysfunction of pseudobulbar palsy(PBP)after cerebral apoplexy(CA).Methods:92 patients with PBP swallowing dysfunction after CA,who met the inclusion criteria,were randomly divided into the observation group and the control group,with 46 cases in each group.The control group was treated with rehabilitation training;on which basis,the observation group was also treated with Jin's three-needle therapy.After 2 weeks of treatment,clinical efficacy,swallowing function,tongue-throat swallowing function of modified Mann assessment of swallowing ability(MMASA),serum neurotrophic factor levels and adverse reactions were compared between the two groups.Results:The total clinical effective rate was significantly higher in the observation group than that in the control group(P<0.05).After 2 weeks of treatment,the water swallow test grading and scores were significantly decreased(P<0.05);the scores of MMASA,the serum levels of NGF,BDNF and IGF-1 were significantly increased(P<0.05);the level of NSE was significantly decreased compared with those before the treatment in the two groups(P<0.05);in which above there were statistical differences between the two groups after the treatment(P<0.05).There were no obvious adverse reactions in the two groups during the treatment.Conclusion:Jin's three-needle combined with rehabilitation training has significant clinical efficacy in treatment of PBP swallowing dysfunction after CA,it can improve swallowing ability and neurological function of tongue and throat.

关 键 词：脑卒中 吞咽功能障碍 靳三针 康复训练 舌喉复合体活动度 神经功能 

分 类 号：R246.6[医药卫生—针灸推拿学]