摘要
目的观察针刺配合吞咽康复疗法治疗中风后假性球麻痹吞咽困难患者的临床疗效。方法将80例中风后假性球麻痹吞咽功能异常患者随机分为治疗组及对照组各40例。对照组在基础治疗同时给予吞咽康复疗法,治疗组在对照组基础上给予针刺治疗,取完骨、风池、翳风、廉泉和咽后壁穴,第1个针刺疗程(10次)为每天1次,第2个针刺疗程(10次)为隔天1次,两个疗程间隔1周。于治疗前及治疗1、2个疗程和随访时(完成两个疗程后3个月)进行澳洲皇家布里斯班医院吞咽功能评定表(RBHOMS)、食物性状和饮料黏稠度评分,并于研究期间观察并发症、体重指数(BMI)及死亡情况。结果治疗组在治疗1、2个疗程及随访时RBHOMS评分较治疗前提高,食物性状(治疗2个疗程及随访时)、饮料黏稠度评分降低(P<0.01)。治疗组随访时较对照组RBHOMS评分升高、食物性状及饮料黏稠度评分降低(P<0.05或P<0.01)。治疗组治疗2个疗程BMI较治疗前降低,而对照组治疗2个疗程及随访时BMI均较治疗前降低(P<0.05)。两组吸入性肺炎及死亡情况比较差异无统计学意义(P>0.05)。结论针刺配合吞咽康复疗法对中风后假性球麻痹吞咽功能有良好的复康效果,其远期疗效优于单纯吞咽复康治疗。
Objective To observe the clinical efficacy of acupuncture combined with swallowing rehabilitation therapy in patients with dysphagia due to pseudobulbar palsy after stroke. Methods Eighty patients with dysphagia due to pseudobulbar palsy after stroke were randomized into treatment group and control group,with 40 cases in each group. The control group received basic treatment plus swallowing rehabilitation,based on which the treatment group was also given acupuncture. For acupuncture,bilateral Wangu（ GB12）,Fengchi（ GB20）,Yifeng（ SJ17）,Lianquan（ RN23） and pharyngeal posterior wall points were selected. During the first course（ 10 times）,the acupuncture was applied once a day,and after one-week interval,the acupuncture was applied once every other day as the second course（ 10 times）. Royal Brisbane Hospital Outcome Measure for Swallowing（ RBHOMS） and food property and drink viscosity score were assessed before treatment,after the first and the second course and in the follow-up（ 3months after two-course treatment）. During the study period,the complications,body mass index（ BMI） and deaths were also observed. Results For the treatment group,after the first and the second course and in the follow-up,the RBHOMS were higher than that before treatment; the food property score（ after the second course and in the follow-up） and the drink viscosity score were lower significantly（ P〈0. 01）. In the follow-up,the RBHOMS in the treatment group was higher than that in the control group,and the food property score and the drink viscosity score were significantly lower（ P〈0. 05 or P〈0. 01）. After the second course,BMI in the treatment group was lower than that before treatment,while in the control group,the BMI after the second course and in the follow-up were both lower than that before treatment（ P〈0. 05）. There was no significant difference of the incidence rate of aspiration pneumonia and mortality rate between the two groups. Conclusion The acupuncture combined with
作者
陈诗玲
倪光夏
CHEN Shiling NI Guangxia(Second School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023 Department of Chinese Medicine, Pok Oi Hospital in Hong Kong)
出处
《中医杂志》
CSCD
北大核心
2017年第5期401-404,共4页
Journal of Traditional Chinese Medicine
关键词
中风
假性球麻痹
吞咽困难
针刺
stroke
pseudobulbar palsy
dysphagia
acupuncture
