涤痰汤联合舌三针对中风后吞咽功能障碍患者舌骨喉活动度、营养状况及脑血流动力学的影响  

Effect of Ditan Decoction Combined with Tongue Three-Needle on Hyoid and Laryngeal Mobility,Nutritional Status,and Cerebral Hemodynamics in Patients with Post-Stroke Dysphagia

作　　者：陈文斌 朱伟新[1] 胡悦怡 吴梦媛[1] CHEN Wenbin;ZHU Weixin;HU Yueyi;WU Mengyuan(Rehabilitation Department of Jinhua Municipal Central Hospital,Jinhua Zhejiang 321000,China)

机构地区：[1]金华市中心医院康复科,浙江金华321000

出　　处：《新中医》2024年第24期16-20,共5页New Chinese Medicine

基　　金：金华市科技局重点课题项目(2023-3-093)。

摘　　要：目的:观察涤痰汤联合舌三针对中风后吞咽功能障碍患者舌骨喉活动度、营养状况及脑血流动力学的影响。方法:将130例中风后吞咽功能障碍患者,按随机数字表法分为对照组和观察组各65例。对照组给予舌三针治疗,观察组在对照组基础上联合涤痰汤治疗。2组均治疗4周。比较2组临床疗效、吞咽功能[洼田饮水试验(WST)评分、标准吞咽功能评价量表(SSA)评分]、舌骨喉活动度、营养状况[肱三头肌皮褶厚度(TSF)、上臂肌围(AMC)、血清白蛋白(Alb)、体质量指数(BMI)]、脑血流动力学指标[最大峰值流速(Vs)、平均流速(Vm)、血管阻力指数(RI)]。结果:观察组总有效率为95.38%,对照组为78.46%,组间比较,差异有统计学意义(P<0.05)。治疗后,2组WST评分、SSA评分均较治疗前降低(P<0.05),且观察组2项评分均低于对照组(P<0.05)。治疗后,2组舌骨上移和前移幅度均较治疗前增加(P<0.05),且观察组舌骨上移和前移幅度均大于对照组(P<0.05);2组甲状软骨上移和前移距离治疗前后比较,差异均无统计学意义(P>0.05)。治疗后,2组Alb、BMI水平均较治疗前升高(P<0.05),且观察组Alb、BMI水平均高于对照组(P<0.05)。治疗后,观察组TSF、AMC水平均较治疗前升高且高于对照组(P<0.05);对照组TSF、AMC水平治疗前后比较,差异无统计学意义(P>0.05)。治疗后,观察组Vs、Vm水平均较治疗前升高(P<0.05),RI值较治疗前降低(P<0.05);且观察组Vs、Vm水平高于对照组(P<0.05),RI值低于对照组(P<0.05)。结论:舌三针联合涤痰汤治疗中风后吞咽功能障碍,可有效改善患者营养状况和脑血流动力学,提高患者舌骨喉活动度,促进吞咽功能恢复。Objective:To observe the effect of Ditan Decoction combined with tongue three-needle on the hyoid and laryngeal mobility,nutritional status,and cerebral hemodynamics of patients with poststroke dysphagia.Methods:A total of 130 patients with post-stroke dysphagia were divided into the control group and the observation group according to the random number table method,with 65 cases in each group.The control group received tongue three-needle treatment,and the observation group received combined treatment with Ditan Decoction on the basis of the control group.Both groups were treated for four weeks.Compared the clinical efficacy,swallowing function[kubota Water Swallowing Test(WST)scores and Standardized Swallowing Assessment(SSA)scores],hyoid and laryngeal mobility,nutritional status[triceps skinfold thickness(TSF),upper arm muscle circumference(AMC),serum albumin(Alb),and body mass index(BMI)],and cerebral hemodynamic indicators[maximum peak flow velocity(Vs),average flow velocity(Vm),and vascular resistance index(RI)]between the two groups.Results:The total effective rate was 95.38%in the observation group,and 78.46%in the control group,the difference being significant(P<0.05).After treatment,both WST and SSA scores were decreased when compared with those before treatment(P<0.05),and both scores in the observation group were lower than those in the control group(P<0.05).After treatment,the amplitude of upward and forward movement of the hyoid bone in both groups was increased when compared with that before treatment(P<0.05),and the amplitude of upward and forward movement of the hyoid bone in the observation group was greater than that in the control group(P<0.05);there was no significant difference in the distance of upward and forward movement of the thyroid cartilage between the two groups before and after treatment(P>0.05).After treatment,both groups showed an increase in levels of Alb and BMI when compared with those before treatment(P<0.05),and the observation group had higher levels of Alb and BMI than the

关 键 词：中风 吞咽障碍 涤痰汤 舌三针 舌骨喉活动度 营养状况 脑血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]