针刺治疗脑卒中后吞咽障碍临床研究  

Clinical Study on Acupuncture Treatment of Dysphagia After Stroke

作　　者：李晓菲 赵东东 覃亮[2] LI Xiaofei;ZHAO Dongdong;QIN Liang(Baoding Hospital,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Baoding 071051,China;Affiliated Hospital of Hebei University,Baoding 071030,China)

机构地区：[1]中国中医科学院广安门医院保定医院,河北保定071051 [2]河北大学附属医院,河北保定071030

出　　处：《山东中医杂志》2025年第4期437-443,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2024070)。

摘　　要：目的:探究针刺在脑卒中后吞咽障碍患者中的应用效果。方法:选取90例脑卒中后吞咽障碍患者,以随机数字表法分为对照组、观察1组、观察2组,每组各30例。对照组接受常规治疗,在此基础上,观察1组进行针刺治疗,不留针,观察2组针刺后留针30 min。对比三组疗效、肠道屏障功能[D-乳酸(D-LA)、脂多糖(LPS)、二胺氧化酶(DAO)]、营养状况[血红蛋白(Hb)及血清白蛋白(ALB)、总蛋白(TP)]、吞咽功能[吞咽造影检查(VFSS)、标准吞咽功能评定量表(SSA)]、胃肠功能、生活质量[Barthel指数(BI)]、睡眠质量[匹兹堡睡眠质量量表(PSQI)]及不良反应。结果:观察1组、2组总有效率分别为83.33%、93.33%,均高于对照组60.00%(均P<0.05);治疗后三组SSA、胃肠功能评分均较治疗前降低,且观察2组<观察1组<对照组(均P<0.05),VFSS评分均升高,且观察2组>观察1组>对照组(均P<0.05);治疗后三组LPS、DAO、D-LA水平均降低,且观察2组<观察1组<对照组(均P<0.05),Hb、ALB、TP水平均升高,且观察2组>观察1组>对照组(均P<0.05);治疗后三组BI评分均升高,且观察2组、1组高于对照组(均P<0.05),三组PSQI评分均降低,且观察2组、1组低于对照组(均P<0.05)。结论:针刺应用于脑卒中后吞咽障碍临床中可提升疗效,改善患者睡眠及生活质量,且针刺后留针对患者吞咽功能、营养状况及肠道屏障功能的改善程度优于不留针方案。Objective:To explore the application effect of acupuncture on patients with dysphagia after stroke.Methods:A total of 90 patients with dysphagia after stroke were selected as the study subjects and divided into the control group,observation group 1 and observation group 2 by using random number table method,with 30 cases in each group.The control group received conventional treatment.On this basis,observation group 1 was treated with acupuncture without needle retention,observation group 2 was treated with needle retention for 30 minutes after acupuncture.The therapeutic effect,intestinal barrier function[D-lactic acid(D-LA),lipopolysaccharide(LPS),diamine oxidase(DAO)],nutritional status[hemoglobin(Hb)and serum albumin(ALB),total protein(TP)],swallowing function[deglutigraphy examination(VFSS),standardized swallowing assessment scale(SSA)],gastrointestinal function and life quality[Barthel Index(BI)],sleep quality[Pittsburgh Sleep Quality Scale(PSQI)]and adverse effects of the three groups were compared.Results:The total effective rate of the observation group 1 and group 2 was 83.33%and 93.33%,respectively,which was higher than that of the control group,60.00%(all P<0.05).After treatment,the SSA and gastrointestinal function scores of the three groups were lower than those before treatment,and observation group 2<observation group 1<the control group(all P<0.05),VFSS scores were increased,and observation group 2>observation group 1>the control group(all P<0.05).After treatment,the levels of LPS,DAO,and D-LA were decreased in all three groups,and observation group 2<observation group 1<the control group(all P<0.05),and the levels of Hb,ALB and TP were increased,and observation group 2>observation group 1>the control group(all P<0.05).After treatment,BI scores in all three groups were increased,and the observation group 2 and group 1 were higher than the control group(all P<0.05),PSQI scores in all three groups were decreased,and the observation group 2 and group 1 were lower than the control group(all P<0.05).Co

关 键 词：脑卒中 吞咽障碍 营养不良 针刺 留针 

分 类 号：R246.6[医药卫生—针灸推拿学] R743.3[医药卫生—中医临床基础]