头针联合吞咽功能康复训练治疗中风后假性球麻痹吞咽障碍患者的临床观察  

Clinical Efficacy of Scalp Acupuncture Combined with Swallowing Function Rehabilitation Training in Treatment of Post-stroke Pseudobulbar Palsy Swallowing Disorders in Patients

作　　者：高爱民[1] 张月娥[1] 李丽杰[1] 徐朝辉[1] 王琳 GAO Ai-min;ZHANG Yue-e;LI Li-jie;XU Zhao-hui;WANG Lin(Rehabilitation Department,Bao Ding No.1 Central Hospital,Baoding Hebei 071000)

机构地区：[1]保定市第一中心医院康复科,河北保定071000

出　　处：《世界中西医结合杂志》2024年第10期2012-2016,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局2018年度中医药类科学研究课题计划项目(2018433)。

摘　　要：目的探讨头针联合吞咽功能康复训练治疗中风后假性球麻痹吞咽障碍患者的临床疗效。方法选取2023年1月—2023年12月期间保定市第一中心医院收治的中风后假性球麻痹吞咽障碍患者80例,按照随机对照试验设计方法分为对照组和观察组,每组各40例。对照组接受康复训练等常规西医治疗,观察组在对照组基础上联合头针治疗。治疗4周后,观察比较两组患者治疗前后中医证候积分、洼田氏饮水试验评分、Barthel指数评分、美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分、吞咽功能评估表(Standardized swallowing assessment,SSA)评分、吞咽障碍特异性生活质量量表(Swallowing quality of life,SWAL-QOL)评分改善状况,并比较两组患者临床总有效率和不良反应发生率。结果治疗后两组患者中医证候积分和洼田氏饮水试验评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分和洼田氏饮水试验评分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Barthel指数评分较治疗前升高,NIHSS评分较治疗前降低,差异有统计学意义(P<0.05);且观察组Barthel指数评分高于对照组,NIHSS评分低于对照组,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);且观察组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)。治疗后观察组临床总有效率92.50%(37/40)高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。治疗期间,两组患者均未出现晕针、血肿等不良反应发生情况。结论头针联合吞咽功能康复训练能改善中风后假性球麻痹吞咽障碍患者的神经损伤程度和吞咽功能,缓解患者临床症状表现,提高吞咽障碍患者生活质量,具有显著的临床疗效。Objective To investigate the clinical efficacy of scalp acupuncture combined with swallowing function rehabilitation training in the treatment of patients with post-stroke pseudobulbar palsy swallowing disorders.Methods Eighty patients with post-stroke pseudobulbar palsy swallowing disorders admitted to Bao Ding No.1 Central Hospital from January to December 2023 were enrolled and randomly divided into a control group and an observation group according to randomized controlled trial design method,with 40 patients in each group.The control group received conventional Western rehabilitation training,while the observation group received scalp acupuncture in addition to the control treatment.After 4 weeks,the two groups were compared in terms of traditional Chinese medicine(TCM)syndrome scores,Watian water swallowing test scores,Barthel index scores,National Institute of Health Stroke Scale(NIHSS)scores,Standardized Swallowing Assessment(SSA)scores,and Swallowing Quality of life(SWAL-QOL)scores before and after treatment,along with overall clinical efficacy and adverse reaction rates.Results After treatment,both groups showed statistically significant reductions in TCM syndrome scores and Watian water swallowing test scores(P<0.05),with the observation group scoring lower than the control group(P<0.05).After treatment,Barthel index scores increased and NIHSS scores decreased in both groups(P<0.05),with the observation group having higher Barthel scores and lower NIHSS scores than the control group(P<0.05).After treatment,SSA scores decreased and SWAL-QOL scores increased in both groups(P<0.05),with the observation group scoring lower on SSA and higher on SWAL-QOL than the control group(P<0.05).The clinical total effective rate was 92.50%(37/40)in the observation group,significantly higher than 75.00%(30/40)in the control group(P<0.05).No adverse reactions such as fainting or hematomas were reported in either group.Conclusion Scalp acupuncture combined with swallowing function rehabilitation training significantly imp

关 键 词：头针 吞咽功能 康复训练 中风后假性球麻痹吞咽障碍 洼田氏饮水试验 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]