高压氧和康复训练联合风池穴针刺治疗假性球麻痹疗效观察

Effect of Hyperbaric Oxygen,Rehabilitation Training or Acupuncture on Pseudobulbar Paralysis

目的评价高压氧和康复训练联合风池穴针刺治疗脑卒中后假性球麻痹的临床效果。方法把90例患者分为Ⅰ(A、B、C)、Ⅱ(A、B、C)组,均给予脑血管病常规治疗,ⅠB和ⅡB组给予高压氧、ⅠC和ⅡC组给予吞咽功能康复训练、Ⅱ组给予风池穴针刺治疗;以自行改良的洼田氏吞咽功能分级标准于治疗前后各时间点评价患者吞咽功能。结果除了ⅠA组,其他5组治疗前后评分均有显著性差异(P<0.05);Ⅰ、Ⅱ组治疗后7个时间点评分组间有显著性差异(P<0.05);除了治疗后3日,在其他时间点,Ⅰ和Ⅱ组评分在亚组间均有显著性差异(P<0.05)。结论高压氧治疗效果优于常规治疗;康复训练优于高压氧;联合风池穴针刺治疗效果优于非针刺治疗。

Objective To observe the effect of hyperbaric oxygen, rehabilitation training or acupuncture at Fengchi aeupoint on pseudobulbar paralysis after stroke. Methods 90 patients were divided into group Ⅰ（A,B,C） or Ⅱ（A,B,C） randomly. Patients in all groups were given conventional therapy, while those in groups ⅠB and ⅡB were given hyperbaric oxygen, ⅠC and Ⅱ C were given swallowing training and group Ⅱ was given acupuncture at Fengchi acupoint additionally. They were assessed with Modified Kubota-Chiari＇s swallowing functional classification before and after treatment. Results In all groups except ⅠA, swallowing function scores improved after treatment significantly （P〈0.05）. The scores were different significantly between group Ⅰ and group Ⅱ after treatment（P〈0. 05）. Except 3 d after treatment, the scores were different significantly between sub group of group Ⅰ or group Ⅱ on other time points （P〈0. 05）. Conclusion The hyperbaric oxygen is more effective than conventional therapy on pseudobulbar paralysis, but less than swallowing training. Acupuncture at Fengchi acupoint can improve their efficacy.