口内穴位点刺疗法联合吞咽康复训练对脑卒中后流涎的临床疗效  

Clinical efficacy of intraoral acupoint acupuncture therapy combined with swallowing rehabilitation training on post-stroke sialorrhea

作　　者：王金金[1,2] 邵蒙蒙 周雪珍[1] 吴文秀[1] 袁拯忠[3] 朱艳艳[1] 卓飞男[1] 李海燕 符文彬[2,4] WANG Jinjin;SHAO Mengmeng;ZHOU Xuezhen;WU Wenxiu;YUAN Zhengzhong;ZHU Yanyan;ZHUO Feinan;LI Haiyan;FU Wenbin(Department of Rehabilitation Medicine,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;The Second Clinical College,Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Department of TCM,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Acupuncture and Moxibustion,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]温州医科大学附属第一医院康复医学科,浙江温州325015 [2]广州中医药大学第二临床医学院,广东广州510120 [3]温州医科大学附属第一医院中医科,浙江温州325015 [4]广东省中医院针灸科,广东广州510120

出　　处：《温州医科大学学报》2025年第3期218-223,229,共7页Journal of Wenzhou Medical University

基　　金：浙江省叶人名老中医专家传承工作室项目(GZS2021030);温州市基础性科研项目(Y2020914)。

摘　　要：目的:评估口内穴位点刺疗法结合吞咽康复训练对脑卒中后流涎(PSS)患者流涎症状的临床疗效。方法:纳入2022年4月至2023年8月在温州医科大学附属第一医院康复医学科收治的62例PSS患者,随机分为治疗组和对照组,分别选用常规针灸针、高仓假针灸针点刺金津、玉液、咽后壁,并接受吞咽康复训练。同时,选取同期30例脑卒中后无流涎患者为无流涎组,作为唾液分泌量的正常对照。治疗周期为4周,治疗前后采用教师流涎量表(TDS)评估流涎严重程度,功能性经口摄食量表(FOIS)评估吞咽功能,并比较PSS患者唾液分泌量的变化。结果:治疗组与对照组患者TDS评级均较治疗前降低(P<0.01),治疗组的降低幅度大于对照组;治疗组治疗后FOIS评级较治疗前提高(P<0.05),但治疗前后两组间FOIS评级差异均无统计学意义(P>0.05);三组在治疗前后的唾液分泌量组间及组内比较差异均无统计学意义(P>0.05)。治疗组治疗前FOIS评级与TDS评级存在弱相关性(rs=0.398,P<0.05),治疗后两组FOIS评级与TDS评级无显著相关性(P>0.05)。结论:口内穴位点刺疗法联合吞咽康复训练能够有效改善脑卒中患者的流涎严重程度,且效果优于假针刺联合吞咽康复训练。Objective:To evaluate the clinical efficacy of intraoral acupoint acupuncture therapy combined with swallowing rehabilitation training on salivation symptoms in patients with post-stroke sialorrhea(PSS).Methods:Sixty-two patients with PSS admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Wenzhou Medical University from April 2022 to August 2023 were included and randomly assigned into a treatment group and a control group,who were respectively treated with conventional acupuncture needles and Takakura sham acupuncture needles to puncture the jinjin(EX-HN 12),yuye(EX-HN 13),and posterior pharyngeal wall and received swallowing rehabilitation training.Meanwhile,30 post-stroke patients without salivation in the same period were selected as the no-salivation group,which served as a normal control for salivary volume.The treatment cycle was 4 weeks,and the severity of sialorrhea was assessed by teacher drooling scale(TDS)and swallowing function was evaluated by the functional oral intake scale(FOIS)before and after the treatment,changes in salivary secretion were compared between patients with PSS.Results:The TDS scores of patients in the treatment group and the control group were all lower than before treatment(P<0.01,P<0.01),and the decrease in the treatment group was greater than in the control group;the FOIS ratings of the treatment group were higher(P<0.05),but the differences in the FOIS ratings of the two groups before and after treatment were not statistically significant(P>0.05);the differences in the amount of salivary secretion of the three groups before and after treatment in the intergroup and intragroup comparisons were not statistically significant(P>0.05);there was a weak correlation between FOIS and TDS in the treatment group before treatment(rs=0.398,P<0.05),and there was no significant correlation between FOIS and TDS in the two groups after treatment(P>0.05).Conclusion:Intraoral acupoint acupuncture therapy combined with swallowing rehabilitation training can

关 键 词：流涎 口内点刺疗法 脑卒中 吞咽康复训练 吞咽功能 

分 类 号：R246.6[医药卫生—针灸推拿学]