耳穴压豆联合半夏厚朴汤加减对脑卒中后吞咽功能障碍患者神经损伤指标的影响  

Influence of Auricular Pressing with Bean Joined with Modified Banxia Houpo Decoction on Nerve Injury Indexes in Patients with Dysphagia after Stroke

作　　者：许蕾 石荣菊 陈寒昱 张超[1] XU Lei;SHI Rongju;CHEN Hanyu;ZHANG Chao(Nanjing Jiangbei Hospital Affiliated to Nantong University,Nanjing 210048,China;Nanjing Normal University of Special Education,Nanjing 210048,China)

机构地区：[1]南通大学附属南京江北医院,江苏南京210048 [2]南京特殊教育师范学院,江苏南京210048

出　　处：《西部中医药》2025年第4期134-138,共5页Western Journal of Traditional Chinese Medicine

基　　金：江苏省教育科学“十三五”规划课题(C-c/2020/01/36);江苏高校“青蓝工程”资助项目(2018SJA0644)。

摘　　要：目的:观察耳穴压豆联合半夏厚朴汤加减对脑卒中后吞咽功能障碍患者神经损伤相关指标的影响。方法:选取100例脑卒中后吞咽障碍患者采用随机数字表法并分为对照组和研究组,每组50例。对照组予半夏厚朴汤加减治疗,研究组同时给予耳穴压豆治疗,两组均治疗1周。比较两组临床疗效,治疗前后神经损伤指标、神经营养指标、炎性因子及生活质量变化情况。结果:治疗后两组吞咽功能、神经损伤指标、神经营养指标、炎性因子及生活质量改善,且研究组洼田饮水试验(water swallow test,WST)评分、标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分及血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)、神经肽Y(neuropeptide tyrosing,NPY)、视锥蛋白样蛋白1(visinin-like protein-1,VILIP-1)、高敏C反应蛋白(high sensitivity C reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)水平均低于对照组(P<0.05);血管内皮生长因子(vascular endothelial growth factor,VEGF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平及吞咽障碍特异性生活质量量表(swallowing quality-of-life questionnaire,SWAL-QOL)评分均高于对照组(P<0.05)。研究组总有效率[94.00%(47/50)]高于对照组[80.00%(40/50)](P<0.05)。结论:耳穴压豆联合半夏厚朴汤加减对改善脑卒中后吞咽障碍患者神经功能及神经营养状态具有积极作用,能够抑制机体炎症反应,促进吞咽功能恢复。Objective:To observe the impacts of auricular pressing with bean and modified Banxia Houpo decoction on nerve injury indexes in patients with dysphagia after stroke.Methods:All 100 patients were allocated to the control group and the study group using the random number table method with 50 cases in each group.The control group orally took modified Banxia Houpo decoction,and the study group was treated with auricular pressing with bean,both groups were treated for one week.To compare clinical effects,nerve injury indexes,neurotrophic factors,inflammatory factors and the changes of quality of life before and after the treatment.Results:After the treatment,the swallowing function,nerve injury indexes,neurotrophic factors,inflammatory factors and quality of life were improved in the two groups,and the study group was lower than the control group in WST scores,SSA scores,and the levels of NSE,NPY,VILIP-1,hs-CRP and IL-6(P<0.05),higher than the control group in the levels of VEGF and BDNF and SWAL-QOL scores(P<0.05).Total effective rate of the study group was[94.00%(47/50)],higher than[80.00%(40/50)]of the control group(P<0.05).Conclusion:Auricular pressing with bean and modified Banxia Houpo decoction present positive effects on the improvements of neurological function and neurotrophic status in patients with dysphagia after stroke which could inhibit inflammatory response of human body and promote the recovery of swallowing function.

关 键 词：脑卒中 吞咽障碍 神经损伤 耳穴压豆 半夏厚朴汤 

分 类 号：R255.2[医药卫生—中医内科学]