醒脑开窍针刺法针刺联合益气扶正活血汤治疗PSD疗效观察  

Therapeutic effects of acupuncture for awakening the mind and opening the orifices combined with a qi-tonifying and blood-circulating decoction on post-stroke dysphagia

作　　者：钱成霞 刘晶 闫明亮 李杠 付春爱 Qian Chengxia;Liu Jing;Yan Mingliang;Li Gang;Fu Chunai(Department of Acupuncture and Moxibustion,Yan'an Hospital of Traditional Chinese Medicine,Yan'an716000,Shaanxi Province,China)

机构地区：[1]延安市中医医院针灸科,延安716000

出　　处：《中国基层医药》2025年第1期93-99,共7页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察醒脑开窍针刺法针刺联合益气扶正活血汤治疗气虚血瘀证卒中后吞咽障碍(PSD)患者的临床效果。方法采用随机对照研究,选取延安市中医医院针灸科2020年1月至2023年3月收治的气虚血瘀证PSD患者86例,采用随机数字表法分对照组、治疗组各43例。对照组接受常规治疗,治疗组接受醒脑开窍针刺法针刺联合益气扶正活血汤治疗,两组疗程1个月。比较两组临床疗效、吞咽功能、血清学指标、漂浮指数及生活质量。结果治疗后,治疗组标准吞咽功能评价量表(SSA)评分为(18.23±2.04)分,低于对照组的(22.52±4.38)分;治疗组洼田饮水试验量表(WST)评分为(2.77±0.55)分,高于对照组的(2.00±0.42)分(t=5.82,7.30,均P<0.05);治疗组超氧化物歧化酶(SOD)[(147.54±21.03)kU/L]高于对照组[(128.31±18.54)kU/L](t=4.50,P<0.05);治疗组脉动指数(PI)[(0.72±0.25)]低于对照组[(0.83±0.24)];脑血管储备(CVR)[(42.28±5.69)%]高于对照组[(35.45±4.31)%](t=0.74、2.03,均P<0.05);治疗组吞咽障碍特异性生活质量量表(SWAL-QOL)评分[(76.33±11.54)分]高于对照组[(68.02±12.16)分](t=3.25,P<0.05)。治疗组有效率为97.67%(42/43),高于对照组的86.05%(37/43),差异有统计学意义(χ^(2)=3.89,P<0.05)。结论醒脑开窍针刺法针刺联合益气扶正活血汤治疗气虚血瘀证PSD卒中后吞咽障碍,相较于常规治疗,显著提升了临床疗效和患者的生活质量。ObjectiveTo investigate the clinical efficacy of acupuncture aimed at awakening the mind and opening the orifices,when combined with a qi-tonifying and blood-circulating decoction,in the treatment of post-stroke dysphagia due to qi deficiency and blood stasis.MethodsA randomized controlled study was conducted involving 86 patients with post-stroke dysphagia due to qi deficiency and blood stasis who were admitted to the Department of Acupuncture and Moxibustion at Yan'an Hospital of Traditional Chinese Medicine from January 2020 to March 2023.The patients were randomly divided into a control group and a treatment group,with 43 cases in each group,using a random number table method.The control group received conventional treatment,while the treatment group received acupuncture aimed at awakening the mind and opening the orifices combined with a qi-tonifying and blood-circulating decoction.Both groups were treated for 1 month.Clinical efficacy,swallowing function,serological indicators,floating index,and quality of life were compared between the two groups.ResultsAfter treatment,the Standardized Swallowing Assessment score in the treatment group was(18.23±2.04)points,which was significantly lower than that in the control group[(22.52±4.38)points,t=5.82,P<0.05].The Water-Swallowing test score in the treatment group was(2.77±0.55)points,which was significantly higher than that in the control group[(2.00±0.42)points,t=7.30,P<0.05].The level of superoxide dismutase in the treatment group was(147.54±21.03)kU/L,which was significantly higher than that in the control group[(128.31±18.54)kU/L,t=4.50,P<0.05].The Pulsatility Index in the treatment group was(0.72±0.25),which was significantly lower than that in the control group[(0.83±0.24),t=0.74,P<0.05].The cerebral vascular reserve in the treatment group was(42.28±5.69)%,which was significantly higher than that in the control group[(35.45±4.31)%,t=2.03,P<0.05].The Swallowing Quality-of-Life Questionnaire score in the treatment group was(76.33±11.54)points,which w

关 键 词：卒中 吞咽障碍 医学 中国传统 针刺疗法 超氧化物歧化酶 生活质量 益气扶正活血汤 

分 类 号：R277.7[医药卫生—中医学]