采用动态荧光透视技术评估头体针治疗中风后吞咽障碍疗效

Videofluoroscopic Evaluation of the Therapeutic Effect of Scalp-body Acupuncture on Post-stroke Dysphagia

目的通过动态荧光透视技术(VFSS)研究头体针治疗中风后吞咽障碍患者的疗效。方法将符合纳入标准的41例患者随机分为针刺组与康复组。针刺组采用头体针治疗,康复组采用现代康复治疗。患者治疗前后均采用洼田饮水试验及VFSS进行临床评估,以比较两组临床疗效。结果治疗3个月后,针刺组总有效率为85.0%,明显高于康复组(66.7%);治疗2星期后,两组患者经VFSS检测,在口期滞留、咽期滞留及误吸、渗透方面发生率均明显减低(P<0.05),两组间比较差异无统计学意义(P>0.05);治疗2星期后,经VFSS检测时间参数,两组在口腔传递时间、咽传递时间、腭咽部关闭时间均明显减少(P<0.05),且针刺组较康复组改善更为显著(P<0.05)。结论头体针治疗可明显缓解中风后吞咽障碍,具有较好的临床疗效。

Objective To investigate the clinical therapeutic effect of scalp-body acupuncture on post-stroke dysphagia by the videofluoroscopic swallowing study （VFSS）. Method Forty-one patients meeting the inclusion criteria were randomly allocated to acupuncture and rehabilitation groups. The acupuncture group received scalp-body acupuncture and the rehabilitation group, modem rehabilitation therapy. A clinical evaluation was made by Kubota＇s water drinking test and VFSS. Result After three months of treatment, the total efficacy rate was 85.0% in the acupuncture group, which was significantly higher than in the rehabilitation group （66.7%）. After two weeks of treatment, VFSS showed that the incidences of oral residue, pharyngeal residue, aspiration and penetration all decreased significantly in the two groups of patients （P〈0.05）; there were no statistically significant differences between the two groups （P〉0.05）. After two weeks of treatment, VFSS time parameter measurement showed that oral transit time, pharyngeal transit time and palatopharyngeal closure time all shortened significantly in the two groups （P〈0.05） and they shortened significantly more in the acupuncture group than in rehabilitation group （P〈0.05）. Conclusion Scalp-body acupuncture can markedly relieve post-stroke dysphagia and has clinically a better therapeutic effect.