摘要
目的:探讨"通关利窍"针刺法配合康复训练治疗缺血性中风后吞咽障碍的临床疗效。方法:将205例患者分为治疗组(100例)和对照组(105例),两组患者均给予常规药物治疗及对症处理,治疗组采用针刺配合康复训练治疗,对照组仅采用康复训练治疗,分别于治疗前、治疗4周后和治疗结束5个月后随访采用洼田饮水试验、藤岛一郎吞咽疗效评价标准、标准吞咽功能评定量表(SSA)评价患者的吞咽功能,以改良的Barthel指数(MBI)评价患者的生活质量,观察临床疗效。结果:两组治疗4周后和治疗结束5个月后与治疗前比较,洼田饮水试验、藤岛一郎吞咽疗效评价标准、SSA及MBI均有显著改善(P<0.01,P<0.05);治疗组与对照组在治疗4周后、治疗结束5个月后洼田饮水试验、藤岛一郎吞咽疗效评价标准、SSA及MBI评分改善均优于对照组(P<0.05);治疗组与对照组治疗4周后总有效率分别为91.00%和56.19%,治疗结束5个月后总有效率分别为98.98%、71.00%,两组疗效差异显著(P<0.05)。结论:"通关利窍"针刺法配合康复训练治疗缺血性中风后吞咽障碍的短期疗效与远期疗效均优于单纯的康复训练治疗,能提高患者生活质量,值得临床推广应用。
Objective： To explore the clinical efficacy of the acupuncture method of ＇Tong Guan Li Qiao＇ combined with rehabilitation therapy for the treatment of dysphagia after ischemic stroke. Methods： A total of 205 cases were divided into 2 groups, 100 cases as treatment group and 105 cases as control group. Both groups were treated with routine medication therapy and symptomatic treatment. The treatment group was treated with acupuncture and rehabilitation training, and the control group was treated only with rehabilitation training. To observe the clinical efficacy, 4 assessments were evaluated at different time, before the treatment, 4 weeks after .the treatment and 5 months after the end of treatment. The Kubota drinking water test, the Ichiro Fujishima swallowing efficacy evaluation criteria and the standard swallowing assessment （SSA） were served as the assessments of swallowing function in patients. The modified Barthel index （MBI） was used for the evaluation of the patients＇ quality of life. Results： The two groups of patients after the treatment four weeks and 5 months after the end of treatment compared with the condition before the treatment, the Kubota drinking water test, the Toshima Ichiro swallowing efficacy evaluation criteria, SSA and MBI had a significant difference （P〈0.05）. After the treatment 4 weeks and 5 months after the end of treatment, the evaluation of the Kubota drinking water test, the Toshima Ichiro swallowing efficacy evaluation criteria, SSA and MBI, the comparison among the treatment group and the control group had a significant difference （P〈0.05）. The treatment group and the control group after 4 weeks＇ treatment, the total effective rate was 91.00% and 56.19%, respectively. Five months after the end of treatment, the total effective rate was 98.98% and 71.00%, respectively. The effects of the two groups had a significant difference （P〈0.05）. Conclusion： The acupuncture method of ＇Tong Guan Li Qiao＇ combined with rehabilitation therapy for the treatment of dysphagia after ischemic stroke, the short-term effect and long-term effect are better than the simple rehabilitation therapy, it can improve the patients＇ quality of life. It is worthy of clinical application.
作者
张丹
张春红
孟智宏
ZHANG Dan;ZHANG Chun-hong;MENG Zhi-hong(lTianjin University of Traditional Chinese Medicine, Tianjin 300193, China;Acupuncture Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2018年第4期1649-1652,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
中医防治中风病技术转化与社区推广研究项目(No.201007002)~~
