摘要
目的:探讨针灸联合会厌通络汤治疗缺血性脑卒中后假性延髓麻痹吞咽困难的临床疗效及对患者误吸发生风险的影响。方法:选取2015年7月至2017年6月中国人民解放军联勤保障部队第九八二医院收治的缺血性脑卒中后假性延髓麻痹吞咽困难患者100例,采用随机数字表法分为对照组50例和观察组50例。对照组患者给予常规治疗(包括抗血小板、降血脂及营养脑神经等),观察组患者在对照组的基础上加用针灸及会厌通络汤,两组患者均治疗4周。观察两组患者的临床疗效、洼田饮水试验评分;动态评价皇家布里斯班医院吞咽功能评定表(the royal brisbane hospital outcome measure for swallowing,RBHOMS)评分变化情况;于治疗后随访6个月,比较两组患者误吸发生风险的差异。结果:治疗4周后,观察组患者的总有效率为92.0%(46/50),明显高于对照组的70.0%(35/50),差异有统计学意义(P<0.05)。治疗后,观察组患者洼田饮水试验评分为(1.52±1.28)分,明显低于对照组的(2.61±1.43)分,差异有统计学意义(P<0.05)。随着治疗时间的延长,观察组患者RBHOMS评分逐渐升高;治疗4周后,观察组患者RBHOMS评分明显高于治疗前,差异有统计学意义(P<0.05)。治疗4周后随访6个月,观察组患者误吸发生率为12.0%(6/50),明显低于对照组的34.0%(17/50),差异有统计学意义(P<0.05)。结论:针灸联合会厌通络汤治疗缺血性脑卒中后假性延髓麻痹吞咽困难的疗效确切,可提高患者吞咽功能,降低误吸发生风险。
OBJECTIVE:To investigate the efficacy of acupuncture and moxibustion combined with epiglottis and tongluo decoction in treatment of dysphagia caused by pseudobulbar paralysis after ischemic stroke.METHODS:100 patients with dysphagia caused by pseudobulbar paralysis after ischemic stroke admitted into 982 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from Jul.2015 to Jun.2017 were extracted to be divided into the control group and the observation group via the random number table,with 50 cases in each group.Patients in the control group were given routine treatment after stroke,including anti-platelet,blood lipid-lowering and nourishing cerebral nerve,while the observation group received acupuncture and moxibustion combined with epiglottis and tongluo decoction on the basis of the control group.Both groups were treated for 4 weeks.The clinical efficacy and the Watian drinking water test score of two groups were observed.Changes in the royal brisbane hospital outcome measure for swallowing (RBHOMS) scores were dynamically evaluated.The follow-up was last for 6 months,differences in the risk of aspiration were compared between two groups.RESULTS:After treatment of 4 weeks,the total effective rate in the observation group was 92.0%(46/50),significantly higher than that in the control group 70.0%(35/50),with statistically significant difference ( P <0.05).After treatment,the Watian drinking water test score of the observation group was (1.52±1.28) points,which was significantly lower than that of the control group (2.61±1.43) points,and the difference was statistically significant ( P <0.05).With the prolonged treatment time,the RBHOMS score of the observation group increased.After 4 weeks of treatment,the RBHOMS score of the observation group was significantly higher than that before treatment,with statistically significant difference ( P <0.05).After 6 months of follow-up,and the risk of aspiration rate was 12.0%(6/50),significantly lower than that of the control group 34.
作者
关艳君
田欢
王胜
吕薇
段世博
GUAN Yanjun;TIAN Huan;WANG Sheng;LYU Wei;DUAN Shibo(Dept.of Traditional Chinese Medicine,982 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Hebei Tangshan 063000,China;Dept.of Neurology,Cangzhou Central Hospital,Hebei Cangzhou 061001,China)
出处
《中国医院用药评价与分析》
2019年第5期563-565,569,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
沧州市科技计划项目(No.151302106)
关键词
缺血性脑卒中
假性延髓麻痹
吞咽困难
针灸
Ischemic stroke
Pseudobulbar paralysis
Dysphagia
Acupuncture and moxibustion
