电针颈枕八穴治疗脑干梗死后延髓麻痹临床观察

Clinical observation on medulla oblongata palsy after brainstem infarction treated with electroacupuncture at eight-neck-occiput points

目的：比较电针颈枕八穴与常规取穴治疗脑干梗死后延髓麻痹之语言、吞咽功能障碍的疗效差异。方法：将72例患者随机分为颈枕组和经穴组，每组36例。颈枕组取颈枕八穴（颈1～4穴、枕1～4穴），经穴组取廉泉、扶突、通里、合谷等穴，两组均行电针疗法，断续波，留针30min，每日1次，每周5次，共治疗4周。观察治疗前后两组患者语言、吞咽功能症状评分变化，并比较两组疗效。结果：治疗后两组语言和吞咽功能评分均显著改善（P〈0．05，P〈0．01），且颈枕组优于经穴组（均P〈0．01）；颈枕组语言功能障碍临床痊愈率、吞咽功能障碍临床痊愈率分别为30．6％（11／36）、22．2％（8／36），优于经穴组的11．1％（4／36）、5．6％（2／36），组间差异有统计学意义（P〈0．01，P〈0．05）。结论：电针颈枕八穴治疗脑干梗死后延髓麻痹之语言、吞咽功能障碍疗效优于电针常规取穴，且定位更准确、操作更安全。

Objective To compare the differences in the efficacy on speech and swallowing dysfunction of medulla oblongata palsy （MOP） after hrainstem infarction between electroacupuncture at eight-neck-occiput points and routine acupoints. Methods Seventy-two patients were randomized into a neck-occiput points group and a meridian points group, 36 cases in each one. In the neck-occiput points group, the eight-neek-occiput points （Neck 1-4 points, Occiput 1-4 points） were selected. In the meridian points group, Lianquan （CV 23）, Futu （LI 18）, Tongli （HT 5）, Hegu （LI 4） and the others were selected. Electroacupuncture was used in the two groups, dense-dispersion wave, retaining for 30 rain. The treatment was given once a day, 5 treatments a week. Totally, 4 weeks were required. The symptom scores of speech and swallowing dysfunction were observed before and after treatment in the two groups. The efficacy was compared between the two groups. Results The scores of speech and swallowing dysfunction were improved significantly after treatment in the two groups （P〈0.05, P〈0.01）. The results in the neck-oeciput points group were better than those in the meridian points group （both P〈0.01）. The curative rate of speech dysfunction was 30.6% （11/36） and that of swallowing dysfunction was 22.2% （8/ 36） in the neck-oeciput points group, which were better than 11.1% （4/36） and 5.6% （2/36） in the meridian points group, respectively. The differences were significant in comparison of the two groups （P〈0. 01, P〈0.05）. Conclusion Electroacupuncture at eight-neck-occiput points achieves a better efficacy on speech and swallowing dysfunction of MOP after brainstem infarction as compared with the routine acupoints. This therapy is characterized as more accurate point localization and safer operation.