项五针联合下颏抗阻力训练治疗脑卒中后吞咽障碍疗效研究  

Curative effect study on combination of nape five-acupoint acupuncture and chin tuck against training on post-stroke oropharyngeal dysphagia patients

作　　者：任倩 蒋天裕[1] 薛勇[2] 瓮长水[1] REN Qian;JIANG Tianyu;XUE Yong;WENG Changshui(People’s Liberation Army General Hospital,Beijing 100853,China;China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]解放军总医院,北京100853 [2]中日友好医院,北京100029

出　　处：《陕西中医》2025年第3期398-402,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划课题(2020YFC2007704)。

摘　　要：目的:探究项五针联合下颏抗阻力训练(CTAR)治疗脑卒中后吞咽障碍(OD)的疗效及对患者表面肌电图、营养状态的影响。方法:选取116例脑卒中后OD患者,随机分为两组,各58例。对照组采用CTAR治疗,研究组采用项五针联合CTAR治疗,比较两组临床疗效、吞咽功能评价量表(SSA)、表面肌电图指标[双侧颏下肌群收缩平均振幅值(AEMG)及持续时间]、营养状态[转铁蛋白(TRF)、白蛋白(ALB)、前白蛋白(PA)]、吞咽生存质量问卷(SWAL-QOL)评分及不良反应。结果:研究组总有效率96.55%大于对照组86.21%(P<0.05)。治疗后,研究组的SSA评分、AEMG、收缩持续时间均低于对照组,研究组的TRF、PA、ALB水平以及SWAL-QOL评分均大于对照组(P<0.05)。结论:项五针联合CTAR治疗脑卒中后OD可增强疗效,提高患者吞咽功能,改善表面肌电图指标及营养状态,优化生活质量,且安全性较高。Objective:To investigate efficacy on combination of nape five-acupoint acupuncture and chin tuck against training(CTAR)on post-stroke oropharyngeal dysphagia(OD)patients and its impacts on surface electromyography and nutritional status.Methods:116 post-stroke OD patients admitted were randomly assigned into two groups.The control group received CTAR treatment,while the study group received combination of nape five-acupoint acupuncture and CTAR treatment.Clinical efficacy,standardized swallowing assessment(SSA),surface electromyographic indicators[average electromyography(AEMG)and duration of bilateral submental muscle group contraction],nutritional status[transferrin(TRF),albumin(ALB),prealbumin(PA)],swallowing quality of life questionnaire(SWAL-QOL)score,and adverse effects were compared between the two groups.Results:The total effective rate of the study group 96.55%was higher than that in the control group 86.21%(P<0.05).After treatment,SSA score,AEMG and systolic duration of the study group were lower than those in the control group,while TRF,PA,ALB levels and SWAL-QOL score of the study group were higher than those in the control group(all P<0.05).Conclusion:The combination of nape five-acupoint acupuncture and CTAR in treating post-stroke OD can enhance efficacy,improve swallowing function,improve surface electromyography indicators and nutritional status,optimize quality of life for patients and improve security.

关 键 词：脑卒中后吞咽障碍 项五针 下颏抗阻力训练 吞咽功能 表面肌电图 营养状态 

分 类 号：R255.2[医药卫生—中医内科学]