舌三针埋针下电刺激治疗脑卒中后吞咽功能障碍的临床研究  

Clinical Study of Electrical Stimulation under Tongue Three-needle Embedding in the Treatment of Dysphagia after Stroke

作　　者：刘雅玲 LIU Yaling(Longyan People's Hospital of Fujian,Longyan,Fujian 364000)

机构地区：[1]福建省龙岩人民医院,福建龙岩364000

出　　处：《中医康复》2025年第2期16-21,共6页Traditional Chinese Medicine Rehabilitation

基　　金：福建中医药大学校管科研课题(XB2022154)。

摘　　要：目的:探讨舌三针埋针下电刺激治疗脑卒中后吞咽功能障碍(DSA)的临床疗效。方法:将90例DSA患者以1:1:1比例随机分为三组,即常规组、舌三针组及舌三针加电组,每组30例,常规组根据病情变化给予中西医基础治疗(西医对照治疗、常规吞咽功能训练、偏瘫肢体常规针刺),舌三针组在常规治疗组基于上增加舌三针治疗,舌三针加电组基于常规治疗组基础增加舌三针埋针下电刺激治疗,三组均治疗4个疗程。采用洼田饮水试验、标准吞咽功能评定量表(SSA)、舌骨喉复合体活动度、改良Barthel指数法(MBI)及吞咽障碍特异性生活质量评分(SWAL-QOL)等指标评估各组的摄食-吞咽功能疗效。结果:舌三针加电组吞咽功能临床总有效率相比舌三针、常规组均有显著提高(P<0.05);治疗4个周后,三组洼田饮水试验评分和SSA评分较治疗前显著降低(P<0.05),三组舌骨上移、前移距离和甲状软骨上移、前移距离较治疗前显著增加(P<0.05),三组MBI评分和SWAL-QOL评分相比治疗前有显著提高趋势(P<0.05),上述指标除舌骨上移、甲状软骨上移及前移距离之外其他指标,三针加电组变化幅度显著大于舌三针组和常规组(P<0.05),舌三针组变化幅度大于常规组(P<0.05)。结论:舌三针埋针下电刺激治疗DSA后能提高摄食-吞咽功能疗效,改善其吞咽功能,提高舌骨喉复合体活动度、日常生活活动能力和生活质量。Objective:To investigate the clinical efficacy of electrical stimulation under tongue three-needle embedding in the treatment of dysphagia after stroke(DAS).Methods:90 cases of DAS patients were randomLy divided into three groups at a ratio of 1:1:1,named conventional group,tongue three-needle group and tongue three-needle+electrical group,with 30 cases in each group.The conventional group was given basic traditional Chinese-Western medicine treatment(western medicine control treatment,routine swallowing function training,routine acupuncture of hemiplegic limbs)according to the changes of disease condition.Based on the above,the tongue three-needle group was treated with tongue three-needle therapy,and the tongue three-needle+electrical group was added with electrical stimulation under tongue three-needle embedding.After 4 courses of treatment,the efficacy of ingestionswallowing function in the three groups was evaluated,and the changes of ingestion-swallowing function[water swallow test,Standard Swallowing Assessment(SSA)],hyoid laryngeal complex movement,modified Barthel index(MBI)and Swallow Quality of Life Questionnaire(SWAL-QOL)were compared among the three groups.Results:The total clinical effective rate of swallowing function in tongue three-needle+electrical group was significantly enhanced than that in tongue three-needle group and conventional group(P<0.05).After 4 weeks of treatment,the scores of water swallow test and SSA in the three groups were significantly reduced than those before treatment(P<0.05).The hyoid bone upward distance and forward distance and thyroid cartilage upward distance and forward distance were significantly enhanced in the three groups compared with those before treatment(P<0.05).The MBI score and SWAL-QOL score in the three groups were significantly risen than those before treatment(P<0.05).Except for hyoid bone upward distance and thyroid cartilage upward distance and forward distance,the changes of the other indicators were significantly greater in tongue three-needle+electr

关 键 词：舌三针埋针下电刺激 脑卒中后吞咽功能障碍 吞咽功能 舌骨喉复合体活动度 生活质量 

分 类 号：R246.1[医药卫生—针灸推拿学]