早期康复训练联合针灸治疗急性脑梗死后吞咽障碍的临床研究

Therapeutic effects of early rehabilitation training combined with acupuncture for dysphagia after cerebral infarction

目的 探讨早期康复训练联合针灸治疗急性脑梗死所致吞咽障碍的临床疗效。方法将100例急性脑梗死后吞咽障碍患者随机分为综合治疗组（康复训练联合针灸治疗）、康复训练组、针灸治疗组及常规药物组，每组患者25例，常规药物组仅采用常规药物治疗，其余3组在接受常规药物治疗基础上给予相应的治疗。4组患者均于治疗前、治疗2周后采用视频吞咽造影检查评价吞咽障碍程度，同时观察4组患者肺部感染的发生率。结果治疗结束后，4组患者与本组治疗前比较，视频吞咽造影检查评分均有提高（P〈0．05）；综合治疗组的视频吞咽造影检查评分和治疗有效率优于其他3组，差异有统计学意义（P〈0．05）；同时，综合治疗组吸入性肺炎发生率也低于其他3组，差异有统计学意义（P〈0．05）。结论急性脑梗死后吞咽障碍患者经早期综合康复训练联合针灸治疗后，能明显改善吞咽功能，减少肺部感染的发生，提高生活质量。

Objective To study the clinical therapeutic effects of early rehabilitation training combined with acupuncture on dysphagia after acute cerebral infarction. Methods One hundred patients with dysphagia caused by acute cerebral infarction were randomly divided into 4 groups： a comprehensive treatment group （25 cases, received rehabilitation training, acupuncture and routine medication） , a routine drug group （25 cases, routine medication） , a rehabilitation group （25 cases, received comprehensive rehabilitation training and routine mediciation） and an acupuncture group （25 cases, received acupuncture therapy and routine medication）. Dysphagia was evaluated with videofluoroscopic swallowing study（VFSS） , and the incidence of pneumonia was observed before treatment and at the 14th day after daily treatment. Results After treatment, the VFSS scores of the 4 groups were significantly higher than before treatment, and VFSS scores in the comprehensive treatment group were significantly higher than those in the other groups. The effectiveness rate in the comprehensive treatment group was significantly higher than that in the other three groups, and the incidence of pneumonia was significantly lower. Conclusions Early rehabilitation combined with acupuncture can improve swallowing and reduce the incidence of aspiration pneumonia in acute stroke patients.