摘要
目的:探讨目的导向性的联合针刺方案对脑卒中吞咽障碍患者口腔期的影响,评估口腔期吞咽障碍康复的优化针刺方案。方法:纳入90例脑卒中后吞咽障碍患者,按照接诊顺序随机分为3组,每组30例。治疗1组患者予头针、项针、舌部及面部综合取穴,并应用电针治疗;治疗2组患者取穴同治疗1组,但不使用电针;对照组患者予常规针刺治疗。各组均治疗4周,观察患者治疗前、治疗后功能性经口摄食评估(FOIS)量表评分、口腔期吞咽功能评分、口腔功能评分及标准吞咽功能(SSA)评分。结果:3组患者治疗后FOIS评分、口腔功能评分均较治疗前升高(P<0.05),VFSS口腔期评分、SSA评分均较治疗前降低(P<0.05);治疗后3组比较,治疗1组患者FOIS评分、口腔功能评分均高于对照组(P<0.05),VFSS口腔期评分、SSA评分均低于对照组(P<0.05);治疗2组患者口腔功能评分高于对照组(P<0.05);3组患者治疗前后FOIS评分、VFSS口腔期评分、口腔功能评分及SSA评分的差值比较,治疗1组与治疗2组患者均高于对照组(P<0.05),并且治疗1组患者均高于治疗2组(P<0.05)。结论:常规吞咽训练基础上,目的导向性的头针联合项针、舌部及面部取穴,并应用电针的针刺方案,能显著改善脑卒中吞咽障碍患者口腔期吞咽功能。并且应用电针的方案疗效更佳。
Objective:To explore the effects of purpose-oriented acupuncture programs on the oral phase of stroke patients with dysphagia,and optimize the treatment schemes of acupuncture.Methods:Totally 90 patients with dysphagia after stroke were randomly divided into three groups,30 cases in each group.The treatment group NO1 was treated with scalp acupuncture,nape acupuncture combined tongue and facial acupoints,and also with electric acupuncture.The treatment method of the treatment group NO2 was the same as that of treatment group NO1,without electroacupuncture.Control group received conventional acupuncture therapy.All cases in three groups were treated for four weeks.The FOIS,Oral phase of swallowing function score,Oral cavity function scale and SSA were observed before and after treatment.Results:After treatment,the FOIS score and Oral cavity function scale increased(P<0.05)while Oral phase of swallowing function score and SSA score decreased in three groups(P<0.05).After treatment,the treatment group NO1 showed higher FOIS score and Oral cavity function scale than control group(P<0.05),while lower Oral phase of swallowing function score and SSA score than control group(P<0.05);the treatment group NO2 showed higher Oral cavity function scale than control group(P<0.05).The treatment group NO1 and treatment group NO2 showed higher D-value of the FOIS,Oral phase of swallowing function score,Oral cavity function scale and SSA than control group(P<0.05),and the treatment group NO1 showed higher D-value than treatment group NO2(P<0.05).Conclusion:Based on conventional swallowing training,the purpose-oriented comprehensive treatment regimen of scalp,nape acupuncture,combined tongue and facial acupoints can significantly improve oral phase swallowing function in stroke patients with dysphagia,and electroacupuncture shows better effect.
作者
秦彦强
姚海江
孙迎春
程先宽
周洁晨
景姗
张强
QIN Yan-qiang;YAO Hai-jiang;SUN Ying-chunu;CHENG Xian-kuan;ZHOU Jie-chen;JING Shan;ZHANG Qiang(China Rehabilitation Research Center/Treatment Center of TCM,Beijing Bo'ai Hospital,Beijing 100068,China;School of Rehabilitation Medicine,Capital Medical University,Beijing 100068,China)
出处
《中医药导报》
2021年第8期96-100,104,共6页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
丰台区卫生计生系统科学研究项目(2016-42)
中国康复研究中心青年基金(2016ZX-Q6)。
关键词
脑卒中
吞咽障碍
口腔期
针刺
头针
项针
电针
stroke
dysphagia
oral phase
acupuncture
scalp acupuncture
nape acupuncture
electroacupuncture
