摘要
目的:观察天突深刺对中风后吞咽障碍患者吞咽功能的影响。方法:70例中风后吞咽障碍患者随机分成治疗组和对照组,每组35例。两组均进行康复训练,治疗组在康复训练的基础上采用天突深刺,对照组采用指南推荐的针灸组穴(风府、双侧百劳、双侧人迎、廉泉、双侧夹廉泉)进行治疗,两组均每周治疗5次,共治疗3周。于入组前及治疗后进行洼田氏饮水试验(KWST)、藤岛一郎吞咽评分(FIRS)及动态吞咽检查(VFSS)。根据以上3项评分计算临床有效率。结果:两组治疗后KWST评分较治疗前均降低,治疗组KWST评分差值大于对照组(P<0.05)。治疗后两组FIRS和VFSS评分较治疗前均升高(P<0.05),治疗组治疗前后评分差值大于对照组(P<0.05)。治疗组总有效率为88.57%(31/35),优于对照组的74.29%(26/35,P<0.05)。结论:天突深刺联合康复训练对中风后吞咽障碍患者的吞咽功能指标均有不同程度的改善,疗效优于使用指南推荐的针灸穴组。
Objective To observe the effect of deep acupuncture of Tiantu(CV22),etc.in combination with rehabilitation training on swallowing function of patients with post-stroke dysphasia.Methods A total of 70 patients suffering from poststroke dysphagia were randomly divided into control group(conventional acupuncture+swallowing rehabilitation training)and treatment group(deep acupuncture of CV22+rehabilitation training,n=35 cases in each group).The swallowing rehabilitation procedure was conducted 30 min every time,twice daily,5 times a week for 3 weeks.In patients of the treatment group,after deep insertion(about 80 mm)along the posterior margin of the manubrium sterna,the filiform needle in CV22 was lifted and thrusted repeatedly 9 times till the patient experienced a feeling of foreign matter blocking,followed by retaining the needle for 30 min.For patients of the control group,Lianquan(CV23)was punctured with 3 acupuncture needles(one vertical needling and bilateral slope needling toward the tongue root),and Fengfu(GV16),bilateral Bailao(EX-NH23),bilateral Renying(ST9)and bilateral Jialianquan(Extra)were punctured vertically with filiform needles.The treatment was conducted once daily,5 times a week for 3 weeks.The swallowing function was evaluated by using Kubota water swallowing test(KWST)scale(0-5 points),Fujishima Ichiro rating scale(FIRS,0-10 points),and video fluoroscopic swallowing study(VFSS,0-10 points),separately.The therapeutic effect was also assessed according to the clinical scale scores and VFSS results.Results Following the treatment,of the two 35 cases in the control and treatment groups,4(11.43%)and 8(22.86%)experienced marked improvement in their symptoms,22(62.86%)and 23(65.71%)were effective,and 9(25.71%)and 4(11.43%)were failed,with the effective rates being 74.29%and 88.57%,respectively.After the treatment,the KWST score of the two groups were significantly decreased in comparison with their own pre-treatment(P<0.05),while the FIRS and VFSS scores of the two groups were considerably increased in comparison with their own pre-treatment(P<0.05).The therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate,lowering KWST score and in raising FIRS and VFSS scores(P<0.05).Conclusion Acupuncture plus swallowing rehabilitation training is effective in improving the swallowing function of stroke patients with dysphagia,and the deep acupuncture stimulation of CV22 is apparently better than conventional acupuncture in the therapeutic effect.
作者
袁盈
蔡向红
陈枫
陈东晓
高莹
刘子祯
凌梦馨
许平
YUAN Ying;CAI Xiang-hong;CHEN Feng;CHEN Dong-xiao;GAO Ying;LIU Zi-zhen;LING Meng-xin;XU Ping(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing University of Chinese Medicine,Beijing 100029;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100700)
出处
《针刺研究》
CAS
CSCD
北大核心
2019年第1期47-50,共4页
Acupuncture Research
基金
中国中医科学院自主选题项目(No.ZZ0908010)
关键词
针刺疗法
中风后吞咽障碍
天突深刺
吞咽康复训练
Acupuncture therapy
Post-stroke dysphagia
Deep acupuncture at Tiantu (CV22)
Swallowing rehabilitation training
