祛风化痰针刺法改善假性球麻痹吞咽功能障碍的多中心临床观察

Multi-center clinical study of acupuncturing to dispell wind and reduce phlegm on swallowing dysfunction caused by false bulbar paralysis

目的系统观察祛风化痰针刺法改善假性球麻痹患者吞咽功能障碍的作用。方法将240例确诊为风痰型假性球麻痹的患者随机分为治疗组和对照组,每组各120例,分别给予祛风化痰针刺法和模拟针刺法治疗,取穴风池(双)、完骨(双)、廉泉、丰隆(双)。每天上、下午各针刺1次,连续6 d为1疗程,疗程间休息1 d,治疗4个疗程。采用洼田饮水试验方法于治疗前、治疗2、4个疗程后进行吞咽功能级别评定,4个疗程后进行疗效评定和比较。结果第2个疗程结束后两组患者的吞咽功能评级与治疗前比较有较显著的提高,差异有统计学意义(P<0.01),治疗组优于对照组(P<0.05);与治疗前比较,第4疗程结束后吞咽功能评级进一步显著提高,差异有统计学意义(P<0.01),治疗组较对照组更优,差异有统计学意义(P<0.01);治疗组的治愈率、显效率和总有效率均显著高于对照组,差异有统计学意义(P<0.01)。结论祛风化痰针刺法改善假性球麻痹患者吞咽功能有肯定、持续且显著的作用,有较大的临床应用价值。

Objective To evaluate the effects of dispelling wind and reducing phlegm acupuncture on improving swallowing function of patients caused by false bulbar paralysis.Methods 240 patients with false bulbar paralysis of wind-phlegm type were randomly divided into two groups,120 patients per group.The patients treated with dispelling wind and reducing phlegm acupuncture in treatment group and in control group with simulation acupuncture,using same acu-points Fengchi,Wangu,Lianquan and Fenglong,one time in morning and in afternoon,6 days a course,one day break between the courses.After 4 courses,swallowing function was investigated by Guitian water-drinking experience before the treatment and after the 2nd course and 4th course,and the effects of two treatment methods were evaluated and compared.Results After the 2nd course,the swallowing function in two groups were improved（P0.01） and the results were more obvious in treatment group than in control group（P0.05）.After the 4th course,swallowing function had improved greatly（P0.01） and the effects were also better in treatment group than in control group（P0.01）;the cure rate,treatment effective rate and total effective rate in treatment group were all significantly higher than those in control group（P0.01）.Conclusion Dispelling wind and reducing phlegm acupuncture has continuous and obvious effects on patients with false bulbar paralysis by improving and recovering swallowing function,which has clinical applicable values.