交叉电项针对脑梗死后气切插管患者吞咽及肺感染的影响

Effect of Crossing Nape Electroacupuncture on Deglutition and Pulmonary Infection in Post-cerebral Infarction Patients with Tracheotomy and Tracheal Intubation

目的观察"交叉电项针"促进脑梗死后气切患者吞咽功能及肺感染恢复的临床疗效。方法以60例咳嗽反射障碍及吞咽功能障碍并肺感染的脑梗死气切插管患者为研究对象,采用随机数字表法随机分为3组,每组20例,按照就诊顺序纳入患者。3组均给予相同的抗炎、化痰、改善供血等基础治疗。交叉电项针组采用双侧风池穴-翳风穴、地仓透颊车、廉泉,电极左右交叉相连;针刺组采用双侧风池穴、翳风穴、地仓透颊车及廉泉,不接电极;对照组进行单纯西药基础治疗,不给于针灸治疗。根据对洼田氏饮水试验评定、藤岛一郎吞咽评价及临床肺部感染评定等指标进行观察,并统计3组治疗后的疗效。结果交叉电项针组洼田饮水试验和藤岛一郎吞咽评价均优于针刺组,针刺组优于对照组(P<0.05);3组CPIS临床肺部感染评分均有降低,交叉电项针组促进肺感染恢复显著(P<0.01)。结论交叉电项针对脑梗死后气管切开插管并吞咽障碍患者有明显改善作用;交叉电项针能够促进脑梗死后气管切开插管并咳嗽反射障碍患者肺感染的恢复。

Objective To investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy. Method Sixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi（GB20）, Yifeng（TE17）, Dicang（ST4）-to-Jiache（ST6） and Lianquan（CV23） acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota＇s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups. Result The therapeutic effects evaluated using the Kubota＇s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group（P0.05）. The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group（P0.01）. Conclusion Crossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.