通督调神针刺联合吞咽治疗仪治疗脑卒中后吞咽障碍的临床观察  

Clinical observation of Tongdu Tiaoshen acupuncture combined with swallowing therapy device in the treatment of post-stroke dysphagia

作　　者：昝兴淳 许季祥 何鹏 齐胤良[1] 周小妹[1] Xingchun Zan;Jixiang Xu;Peng He;Yinliang Qi;Xiaomei Zhou(Department of Hyperbaric Oxygen Medicine,Hefei Second People's Hospital,Hefei 1230011,China;Department of Rehabilitation Medicine,Hefei Second People's Hospital,Hefei 1230011,China)

机构地区：[1]合肥市第二人民医院高压氧医学科,合肥230011 [2]合肥市第二人民医院康复医学科,合肥230011

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第6期346-352,共7页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：安徽省教育厅项目(KJ2020A0216);合肥市第二人民医院青年科研基金项目(2021yqn11);蚌埠医学院自然科学科技基金项目(2022byzd208)

摘　　要：目的观察通督调神针刺疗法联合吞咽治疗仪对脑卒中后吞咽障碍(PSD)患者吞咽功能的影响。方法选取自2021年6月至2023年6月于合肥市第二人民医院接受康复治疗的100例PSD患者作为研究对象,依据随机数字表法将患者分为观察组(50例)和对照组(50例)。对照组常规进行吞咽功能训练联合吞咽治疗仪,观察组在对照组的基础上联合采用通督调神针刺法。治疗前和治疗3周后,分别采用标准吞咽功能评价量表(SSA)、功能性经口摄食量表(FOIS)评估患者的吞咽功能和经口摄食功能,记录患者的口腔运送时间(OTT)、咽运送时间(PTT)、舌骨向上位移(HSM)、环咽肌开放幅度(UO)、营养支持时间、自主进食时间、住院时间及不良反应发生情况,评估患者的营养状况及预后,根据治疗前后洼田饮水试验分级变化判定临床疗效。结果治疗3周后,2组患者的SSA评分较本组治疗前降低,FOIS评分较本组治疗前升高,且观察组SSA评分低于对照组,FOIS评分高于对照组,差异均有统计学意义(P<0.05);2组患者的OTT、PTT较本组治疗前降低,HSM、UO较本组治疗前升高,且观察组OTT、PTT低于对照组,HSM、UO高于对照组,差异均有统计学意义(P<0.05)。观察组患者的营养支持时间、自主进食时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组的治疗总有效率为96.0%,高于对照组(86.0%),差异有统计学意义(P<0.05)。结论采用通督调神针刺联合吞咽治疗仪治疗PSD,能改善患者口腔期、咽期吞咽情况,促使自主进食,减少营养支持以及住院时间,缩短经口进食时间,有助于改善PSD。Objective To observe the effect of Tongdu Tiaoshen acupuncture combined with swallowing therapy device on swallowing function in patients with post-stroke dysphagia(PSD).Methods One hundred PSD patients admitted to Hefei Second People&apos;s Hospital for rehabilitation from June 2021 to June 2023 were selected as the research subjects.According to the random number table method,the patients were divided into an observation group(n=50)and a control group(n=50).The control group received routine swallowing function training combined with a swallowing therapy device,while the observation group used the Tongdu Tiaoshen acupuncture method in combination with the control group.The patient&apos;s oral transit time(OTT),pharyngeal transit time(PTT),hyoid bone superior movement(HSM),and upper esophageal opening(UO)of the cricopharyngeal muscle,nutritional support time,autonomous feeding time,hospitalization time,and incidence of adverse reactions were recorded.The patient&apos;s nutritional status and prognosis were evaluated,and the clinical efficacy was determined based on the grading changes of the water swallowing test(WST)before and after treatment.Results After treatment,the SSA scores of both groups decreased compared to before treatment,while the FOIS scores increased compared to before treatment,the SSA scores of the observation group were lower than that of the control group,and the FOIS scores were higher than that of the control group,with statistically significant differences(P<0.05).After treatment,the OTT and PTT of both groups decreased compared to before treatment,while HSM and UO increased compared to before treatment,the observation group had lower OTT and PTT than the control group,while HSM and UO were higher than the control group,with statistically significant differences(P<0.05).The nutritional support time,independent eating time,and hospitalization time of the observation group patients were shorter than those of the control group,and the differences were statistically significant(P<0.05).The tot

关 键 词：脑卒中 吞咽障碍 通督调神针刺 吞咽治疗仪 吞咽造影录像检查 

分 类 号：R743.3[医药卫生—神经病学与精神病学]