颈项部穴位深刺联合推拿治疗脑卒中后吞咽障碍临床研究  

Clinical Study on Deep Acupuncture on Neck Acupoints Combined with Massage for Post-Stroke Swallowing Disorder

作　　者：孙晓东[1] 陈涛[1] 杜振峰[1] 张士金[1] SUN Xiaodong;CHEN Tao;DU Zhenfeng;ZHANG Shijin(People's Hospital of Zhengzhou,Zhengzhou Henan 450003,China)

机构地区：[1]郑州人民医院,河南郑州450003

出　　处：《新中医》2025年第4期73-77,共5页New Chinese Medicine

基　　金：郑州市中医临床技术骨干人才培养项目(郑卫中管函2024-5);郑州市中医药学科领军人才培养项目(郑卫中管函2021-11)。

摘　　要：目的:观察颈项部穴位深刺联合推拿治疗脑卒中后吞咽障碍的临床疗效。方法:选取2022年7月—2024年1月郑州人民医院收治的90例脑卒中后吞咽障碍患者,按随机数字表法分为观察组、对照1组和对照2组,每组30例。3组均实施常规治疗,在此基础上,对照1组采用推拿治疗,对照2组采用颈项部穴位深刺治疗,观察组采用颈项部穴位深刺联合推拿治疗。3组均连续治疗3个月。比较3组临床疗效、标准吞咽功能评价量表(SSA)评分、舌骨活动度、吞咽障碍特异性生命质量量表(SWAL-QOL)评分及不良反应发生情况。结果:治疗3个月后,总有效率观察组93.33%(28/30),均高于对照1组70.00%(21/30)和对照2组73.33%(22/30),差异均有统计学意义(P<0.05)。3组SSA、SWAL-QOL评分均较治疗前降低,观察组SSA、SWAL-QOL评分均低于对照1组和对照2组,差异均有统计学意义(P<0.05)。3组舌骨向上移位、向前移位值均较治疗前增大,观察组舌骨向上移位、向前移位值均大于对照1组和对照2组,差异均有统计学意义(P<0.05)。3组治疗期间均未出现明显不良反应。结论:颈项部穴位深刺联合推拿治疗脑卒中后吞咽障碍临床疗效确切,可有效改善临床症状,促进吞咽功能恢复,提高生活质量,且安全性好。Objective:To observe the clinical effect of deep acupuncture on neck acupoints combined with massage on post-stroke swallowing disorder.Methods:A total of 90 patients with post-stroke swallowing disorder were selected from People's Hospital of Zhengzhou from July 2022 to January 2024 and divided into the observation group,the control group one and the control group two according to random number table method,with 30 cases in each group.All the three groups were treated with conventional treatment.On this basis,the control group one was treated with massage;the control group two was treated with deep acupuncture on neck acupoints,and the observation group was treated with deep acupuncture on neck acupoints combined with massage.All the three groups were treated for three months continuously.The clinical effects,scores of Standardized Swallowing Assessment(SSA),hyoid motion,scores of Swallowing Quality of Life(SWAL-QOL)and the incidence of adverse reactions were compared among the three groups.Results:After three-month treatment,the total effective rate was 93.33%(28/30)in the observation group,higher than that of 70.00%(21/30)in the control group one and that of 73.33%(22/30)in the control group two,with statistical significant differences(P<0.05).The SSA and SWAL-QOL scores in the three groups were decreased when compared with those before treatment,and the SSA and SWAL-QOL scores in the observation group were lower than those in the control group one and the control group two,with statistical significant differences(P<0.05).The values of upward and forward hyoid displacement in the three groups were increased when compared with those before treatment,and the values of upward and forward hyoid displacement in the observation group were higher than those in the control group one and the control group two,with statistical significant differences(P<0.05).There were no obvious adverse reactions in the three groups during treatment.Conclusion:Deep acupuncture on neck acupoints combined with massage has a definite clin

关 键 词：脑卒中 吞咽障碍 颈项部穴位深刺 推拿 吞咽功能 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]