针刺配合康复疗法治疗中风后吞咽障碍57例临床研究

A Clinical Study on Acupuncture Combined with Rehabilitation Therapy for 57 Cases of Swallowing Disorders after Stroke

目的观察针刺配合康复疗法治疗中风后吞咽障碍的临床疗效。方法将113例患者随机分为针康组57例和康复组56例。两组患者均给予常规脑血管病治疗方案,康复组单纯采用康复治疗,针康组采用醒脑开窍针刺加康复治疗,针刺与康复均每日1次,两组均10天为1个疗程,连续治疗3个疗程。两组患者于治疗前后进行标准吞咽功能评分(SSA)、吞咽障碍特异性生活质量量表(SWAL-QOL)评分并观察肺感染率,采用洼田饮水试验进行疗效评价。结果针康组总有效率为85.96%,康复组为69.64%,针康组总有效率明显优于康复组(P<0.05)。两组患者治疗后SSA和SWAL-QOL评分均较治疗前明显改善(P<0.01);针康组治疗后SSA和SWAL-QOL评分改善均明显优于康复组(P<0.01)。两组患者肺感染率比较,差异无统计学意义(P>0.05)。结论针刺配合康复疗法在改善中风后吞咽障碍患者吞咽功能、提高生活质量方面具有确切疗效。

Objective To observe the therapeutic effect of acupuncture for swallowing disorders after stroke. Methods To- tally 113 patients were randomized into the combo therapy group （acupuncture ^- rehabilitation therapy） and rehabilitation group （rehabilitation therapy）, with 57 and 56 in each. Both groups were given the conventional therapy for cerebrovascular disease. The rehabilitation group was given rehabilitation therapy and the combo therapy group was given consciousness-resto- ring and orifice-opening （CROO） acupuncture combined with rehabilitation therapy. The acupuncture and rehabilitation therapy was given to the patients once daily for 3 consecutive treatment courses. One treatment course lasted for 10 days. The stand- ardized swallowing assessment （SSA）, quality of life in swallowing disorders （SWAL-QOL） and lung infection rate was ob- served. The therapeutic effect was evaluated by bedside water swallow test. Results The total effective rate of the combo therapy group and rehabilitation group was 85.96% and 30.36% respectively, with a significant difference between groups （P〈0. 05）. The scores of SSA and SWAL-QOL were significantly improved in both groups after treatment （P〈0. 01）, espe- cially in the combo therapy group （P〈0.01）. There was no significant difference between groups in the lung infection rate （P〉0.05）. Conclusion The CROO acupuncture is effective in improving the swallowing function and QOL for swallowing disorders after stroke,