针刺联合吞咽康复训练治疗卒中后吞咽障碍87例

Clinical Effect of Acupuncture Combined with Swallowing Rehabilitation Training in Treatment of Dysphagia after Stroke:A Report of 87 Cases

目的观察针刺联合吞咽康复训练治疗卒中后吞咽障碍的临床疗效。方法将174例卒中后吞咽障碍患者随机分为治疗组和对照组,每组87例。治疗组给予针刺联合吞咽康复训练,对照组仅给予吞咽康复训练,隔日1次,2周为1个疗程,治疗60d后评价临床疗效,治疗后3个月进行随访。采用洼田饮水试验和藤岛一郎吞咽障碍评分标准进行疗效评价。结果与前一时点比较,两组治疗后和随访后洼田饮水试验评分均显著降低(P<0.01),藤岛一郎吞咽障碍评分均显著升高(P<0.01);随访后,治疗组洼田饮水试验评分降低值及藤岛一郎吞咽障碍评分升高值显著大于对照组(P<0.01)。治疗组吞咽障碍复常率及临床疗效显著优于对照组(P<0.05)。结论在吞咽康复训练的基础上,联用针刺疗法可提高卒中后吞咽障碍的临床疗效。

Objective To observe the clinical effect of acupuncture combined with swallowing rehabilitation training in the treatment of dysphagia after stroke.Methods A total of 174 patients with dysphagia after stroke were randomly divided into treatment group （n=87） and control group （n=87）.The treatment group received acupuncture combined with swallowing rehabilitation training,while the control group received swallowing rehabilitation training alone.Treatment was performed once every other day,and each course of treatment was two weeks.The treatment outcomes were assessed after 60 d of treatment,and follow up was performed at 3 months after treatment.The water swallow test （WST） and Toshima Ichiro swallowing efficiency score were used to evaluate the treatment outcomes.Results After treatment and at follow up,both groups showed significant decreases in WST score （P＜0.01） and significant increases in Toshima Ichiro swallowing efficiency score （P＜0.01）; at follow-up,the treatment group had a significantly higher decrease in WST score and a significantly higher increase in Toshima Ichiro swallowing efficiency score compared with the control group （P＜0.01）.The treatment group had a significantly higher swallowing normalization rate and a significantly better clinical outcome compared with the control group （P＜0.05）.Conclusion Acupuncture combined with swallowing rehabilitation training can improve the treatment outcome of dysphagia after stroke.