针灸联合按摩治疗脑瘫合并吞咽障碍的临床研究

A clinical study on cerebral palsy with dysphagia by acupuncture combined with massage treatment

目的:观察针灸联合按摩治疗脑瘫合并吞咽障碍的临床疗效。方法:将符合纳入标准的61例脑瘫合并吞咽障碍的患儿随机分为治疗组和对照组,其中治疗组31例,对照组30例。治疗组采用针灸联合按摩治疗,对照组采用吞咽功能训练和吞咽治疗仪治疗。2组患儿疗程均为12周,分别于治疗前、后采用Sheppard的吞咽障碍调查问卷(DDS)、才藤荣一吞咽障碍7级评价方法和Kaup指数进行疗效评价。结果:治疗前2组患儿的DDS评分比较,差异无显著性意义(P>0.05),治疗后2组患儿的DDS评分均有改善,治疗组优于对照组(P<0.05);治疗前两组患儿才藤荣一吞咽障碍7级评价相互比较,差异无显著性意义(P>0.05)。治疗后才藤荣一吞咽障碍7级评价,两组患儿疗效相当(P>0.05);两组患儿总体疗效比较,治疗组患儿总有效率为90.32%,对照组为83.33%,经统计学分析无显著性差异(P>0.05),Kaup指数治疗组患儿的正常率优于对照组(P<0.05)。结论:针灸配合按摩疗法与吞咽功能训练和吞咽治疗仪疗法均能有效地改善脑瘫患儿的吞咽功能,且针灸按摩疗法能很好地改善患儿的营养状况,提高其生存质量,可作为一种有效的治疗方法应用于临床。

Objective：To observe the curative effects of combination treatment of acupuncture and massage in treating cerebral palsy with dysphagia. Method：Sixty-one cases with cerebral palsy with dysphagia conformed to the conclusion criteria were randomized into the treatment group （31 cases, treated with acupuncture combined with massage） and the control group 30 cases（treated with deglutition training and swallowing therapeutic apparatus）. Both of the two groups were treated for 12 weeks.The curative effects were evaluated before and after the treatment by the methods of dysphagia disorders survey（DDS）, the Saito 7 grades of swallowing disorder and Kaup index. Result：Before treatment, the difference between the two groups on DDS scoring was not statistically significant （P〉0.05）. After treatment, both of the two groups improved on the DDS scoring, and the treatment group was superior to the control group （P〈0.05）.Before the treatment, difference between the two groups on curative effects evaluated by Saito 7 grades of swallowing disorder was not statistically significant （P〉0.05）. After treatment, there was no significant difference between the two groups on Saito 7 grades of swallowing disorder（P〉0.05）. The total curative rate of the treatment group was 90.32%, the control group was 83.33%, and there was no significant difference by statistical analysis （P〉0.05）. The Kaup index showed that the normal rate of the treatment group was higher than that of the control group （P〈0.05）. Conclusion：Both of the two therapies of acupuncture combined with massage and deglutition training combined with swallowing therapeutic apparatus all can effectively improve the swallowing function of children with cerebral palsy, and the treatment of acupuncture combined with massage can improve the children＇s nutritional status and quality of life, better and can be applied to the clinic.